An updated estimate of costs of endophthalmitis following cataract surgery among Medicare patients: 2010–2014

Abstract

BackgroundEndophthalmitis, which can occur after ophthalmic surgery, is an inflammation of the intraocular cavity and causes temporary or permanent vision impairment. However, little is known about the cost of treatment. The objective of this analysis was to update and expand upon the results of a previously published report that estimated the direct medical cost of treatment for endophthalmitis.MethodsRetrospective data analysis using 2010 through 2014 United States Medicare Limited Data Sets. Procedure codes were used to identify beneficiaries who underwent cataract surgery; demographic and clinical characteristics at the time of diagnosis were determined. Patients were stratified into cases (those who developed endophthalmitis) and controls (those who did not develop endophthalmitis) in the 3 months following surgery. Claims (ie, charges) and reimbursements (ie, costs) for cases and controls in the 6 months following cataract surgery were identified and compared. Results are presented in 2015 US dollars.ResultsOf a total of 153,860 cataract surgery patients, 181 were diagnosed with endophthalmitis following cataract surgery, at a rate of 1.2 per 1,000. Cases were more likely to be male and less likely to be white than controls; age was similar. Total medical claims and reimbursements as well as ophthalmic claims and reimbursements were significantly higher for cases compared with controls. Total reimbursements, adjusted for age, sex, and region, were $4,893 higher (83% greater) and adjusted ophthalmic reimbursements were $3,002 higher (156% greater) for cases than for controls. Claims and reimbursements were significantly higher across all types of Medicare cost components.ConclusionPostcataract surgery endophthalmitis is associated with a substantial cost. Successful prophylaxis with antibiotic agents would reduce the significant costs associated with treating endophthalmitis.

Incidence and Characteristics of Endophthalmitis after Cataract Surgery in Poland, during 2010–2015

“…During the study period, the use of an intracameral antibiotic injection at the end of the cataract surgery was not officially reported in the NFZ national database of hospitalizations as well as other possible risk factors such as surgical complications and the type of intraocular lens (IOL) used. However, the cost-effectiveness of the use of intracameral antibiotics in reduction of the substantial costs associated with the treatment of POE after cataract surgery is well known [22].…”

Incidence and Characteristics of Endophthalmitis after Cataract Surgery in Poland, during 2010-2015

“…It needs a further evaluation as well as the cost-effectiveness of this prophylaxis to reduce the substantial costs associated with the treatment of POE after cataract surgery. [22]…”

Quantifying the real-world cost saving from using surgical adjuncts to prevent complications during cataract surgery

“…Schmier et al used United States Medicare Limited Data Sets to identify patients who had developed a specific complication (postoperative CMO; postoperative endophthalmitis) following cataract surgery and those who did not ("controls") [25][26][27][28]. By considering the total reimbursements paid, they identified the increased cost of managing these complicated cases in both instances.…”

“…By considering the total reimbursements paid, they identified the increased cost of managing these complicated cases in both instances. In the case of CMO, this was an 85% increase vs "control" ($2720 vs $1470), and in the case of endophthalmitis, a 78% increase ($11,551 vs $6488) [27,28]. In these examples, the additional increased cost of complication-related CMO and endophthalmitis have been estimated in the USA system to be in the region of $1250 and $5000, respectively.…”