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Treatment costs of cystoid macular edema among patients following cataract surgery

PURPOSE: The current costs of treating cystoid macular edema (CME), a complication that can follow cataract surgery, are largely unknown. This analysis estimates the treatment costs for CME based on the recently released US Medicare data. SETTING: Nationally representative database. DESIGN: Retrospe...

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Autores principales: Schmier, Jordana K, Covert, David W, Hulme-Lowe, Carolyn K, Mullins, Anmol, Mahlis, Emmanuel M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801125/
https://www.ncbi.nlm.nih.gov/pubmed/27041989
http://dx.doi.org/10.2147/OPTH.S98892
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author Schmier, Jordana K
Covert, David W
Hulme-Lowe, Carolyn K
Mullins, Anmol
Mahlis, Emmanuel M
author_facet Schmier, Jordana K
Covert, David W
Hulme-Lowe, Carolyn K
Mullins, Anmol
Mahlis, Emmanuel M
author_sort Schmier, Jordana K
collection PubMed
description PURPOSE: The current costs of treating cystoid macular edema (CME), a complication that can follow cataract surgery, are largely unknown. This analysis estimates the treatment costs for CME based on the recently released US Medicare data. SETTING: Nationally representative database. DESIGN: Retrospective analysis of the 2011 through 2013 Medicare 5% Beneficiary Encrypted Files. METHODS: Beneficiaries who underwent cataract surgery were identified and stratified by diagnosis of CME (cases) or no diagnosis of CME (controls) within 6 months following surgery. Claims and reimbursements for ophthalmic care were identified. Subgroup analyses explored the rates of CME in beneficiaries based on the presence of selected comorbidities and by the type of procedure (standard vs complex). Total Medicare and ophthalmic costs for cases and controls are presented. The analysis explored the effect of considering diabetic macular edema (DME) and macular edema (ME) as exclusion criteria. RESULTS: Of 78,949 beneficiaries with cataract surgery, 2.54% (n=2,003) were diagnosed with CME. One-third of beneficiaries had one or more conditions affecting retinal health (including diabetes), 4.5% of whom developed CME. The rate of CME, at 22.5%, was much higher for those patients with preoperative DME or ME. Ophthalmic charges were almost twice as high for cases compared with controls (US$10,410 vs $5,950); payments averaged 85% higher ($2,720 vs $1,470) (both P<0.0001). CONCLUSION: Substantial costs can be associated with CME; beneficiaries whose retinas are already compromised before cataract surgery face higher risk. Cost savings could be realized with the use of therapies that reduce the risk of developing CME. Future analyses could identify whether and to what extent comorbidities influence costs.
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spelling pubmed-48011252016-04-01 Treatment costs of cystoid macular edema among patients following cataract surgery Schmier, Jordana K Covert, David W Hulme-Lowe, Carolyn K Mullins, Anmol Mahlis, Emmanuel M Clin Ophthalmol Original Research PURPOSE: The current costs of treating cystoid macular edema (CME), a complication that can follow cataract surgery, are largely unknown. This analysis estimates the treatment costs for CME based on the recently released US Medicare data. SETTING: Nationally representative database. DESIGN: Retrospective analysis of the 2011 through 2013 Medicare 5% Beneficiary Encrypted Files. METHODS: Beneficiaries who underwent cataract surgery were identified and stratified by diagnosis of CME (cases) or no diagnosis of CME (controls) within 6 months following surgery. Claims and reimbursements for ophthalmic care were identified. Subgroup analyses explored the rates of CME in beneficiaries based on the presence of selected comorbidities and by the type of procedure (standard vs complex). Total Medicare and ophthalmic costs for cases and controls are presented. The analysis explored the effect of considering diabetic macular edema (DME) and macular edema (ME) as exclusion criteria. RESULTS: Of 78,949 beneficiaries with cataract surgery, 2.54% (n=2,003) were diagnosed with CME. One-third of beneficiaries had one or more conditions affecting retinal health (including diabetes), 4.5% of whom developed CME. The rate of CME, at 22.5%, was much higher for those patients with preoperative DME or ME. Ophthalmic charges were almost twice as high for cases compared with controls (US$10,410 vs $5,950); payments averaged 85% higher ($2,720 vs $1,470) (both P<0.0001). CONCLUSION: Substantial costs can be associated with CME; beneficiaries whose retinas are already compromised before cataract surgery face higher risk. Cost savings could be realized with the use of therapies that reduce the risk of developing CME. Future analyses could identify whether and to what extent comorbidities influence costs. Dove Medical Press 2016-03-16 /pmc/articles/PMC4801125/ /pubmed/27041989 http://dx.doi.org/10.2147/OPTH.S98892 Text en © 2016 Schmier et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Schmier, Jordana K
Covert, David W
Hulme-Lowe, Carolyn K
Mullins, Anmol
Mahlis, Emmanuel M
Treatment costs of cystoid macular edema among patients following cataract surgery
title Treatment costs of cystoid macular edema among patients following cataract surgery
title_full Treatment costs of cystoid macular edema among patients following cataract surgery
title_fullStr Treatment costs of cystoid macular edema among patients following cataract surgery
title_full_unstemmed Treatment costs of cystoid macular edema among patients following cataract surgery
title_short Treatment costs of cystoid macular edema among patients following cataract surgery
title_sort treatment costs of cystoid macular edema among patients following cataract surgery
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801125/
https://www.ncbi.nlm.nih.gov/pubmed/27041989
http://dx.doi.org/10.2147/OPTH.S98892
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