Ambulatory surgery centers: possible solution to improve cataract healthcare in medical deserts

Abstract

Purpose: To investigate the epidemiological impact of an ambulatory cataract surgery center providing a fast-track procedure without anesthetic evaluation on the access to cataract healthcare. Setting: French nationwide study. Design: Retrospective cross-sectional study. Methods: The study included individuals undergoing cataract surgery from the French national administrative database of medical information. Data analyses focused on patients living in the Cher and neighboring areas. Epidemiological indicators of patient flow and healthcare efficiency were calculated. A medicoeconomic analysis was performed. Results: Between 2012 and 2018, activity increased by +50.2% (3665 to 5506) interventions in the Cher area compared with a national increase of +22.7% (720 351/884 254), while maintaining a constant ophthalmologist workforce. The leakage ratio decreased by 5.9 points (26.3% to 20.4%), whereas the attractiveness and self-sufficiency ratios increased by 2.3 (8.6% to 10.9%) and 8.6 (80.6% to 89.2%) points, respectively. The age- and sex-standardized rate of healthcare utilization for cataract surgery increased by 4.3 points (11.6 to 15.9 cataract surgeries per 1000 inhabitants), making the Cher the second best French area in 2018 for the rate of cataract surgery despite ranking 96th of 109 French areas for ophthalmologist density. The cost of the cataract removal procedure was 523.99€ (666.22€ in the conventional operating room). Conclusions: An ambulatory cataract surgery center with a fast-track procedure could represent a solution in medical deserts to improve cataract healthcare without supplementary funding. Nonetheless, consulting activity should be optimized to detect eye disorders and schedule interventions.

Outpatient Spine Surgery in Poland: A Survey on Popularity, Challenges, and Future Perspectives

“… 19 Open procedures, such as inguinal hernia surgery, or even very precise procedures, such as cataract correction, have also entered the repertoire of outpatient procedures. 20 , 21 …”

“…19 Open procedures, such as inguinal hernia surgery, or even very precise procedures, such as cataract correction, have also entered the repertoire of outpatient procedures. 20,21 Spine surgery is another field within the scope of one-day surgery, which is particularly noticeable in highly developed countries with a free-market model of health care financing. 22 In Poland, outpatient spinal surgeries are an extremely rare phenomenon, and as of the date of preparation of the following study, only three centers in Poland perform them in this format.…”

Educational Concerns About the Safety of Cataract Surgery During Residency: The E3CAPS Pedagogic Study

“…Cataract surgery is the most common surgical procedure in France, with 884,254 cataract surgeries in 2018) [ 1 ]. The procedure is performed under an operating microscope and requires high levels of precision and attention from the surgeon.…”