Description of Day Case Costs and Tariffs of Cataract Surgery From a Sample of Nine European Countries

Abstract

BackgroundThe lack of transparency in the methodology of unit cost estimation and the usage of confidential or undisclosed information prevents cost comparison and makes the transferability of the results across countries difficult. The objective of this article is to compare the methodologies used in the estimation of the cost of a day case cataract extirpation that are described in the official sources. MethodsA semi-structured questionnaire regarding information on costing methodologies was developed and sent to consortium partners. Additionally, publicly available sources of unit cost of cataract surgery of nine European countries were searched and analysed. ResultsThe findings showed a considerable diversity across countries on unit costs varying from 432.35€ in Poland (minor degree of severity) to 3,411.96€ in Portugal (major degree of severity). In addition, differences were found in the frequency of updating the costs and on the level of detail of different types of cataract surgery. The unit of activity were Diagnosis-Related Groups in all countries except Slovenia. All unit costs include direct costs and variable overheads (except Germany where nursing costs are financed separately). Differences in unit costs across countries may be driven by fixed overheads. Methodological documents explaining the identification, measurement and evaluation of resources included in the unit costs with exception of England are not publicly available. ConclusionsWe can conclude that while unit costs of cataract extirpation are publicly available, the information on methodological aspects is very scarce. This appears to pose a significant problem for cross-country comparisons of costs and transferability of results from one country to another.