Many Cataract Patients Undergo Unnecessary Pre-Op Testing
(HealthDay News) — Many patients still undergo preoperative testing before cataract surgery despite recommendations against it, according to a study published in the April 16 issue of the New England Journal of Medicine.
Noting that routine preoperative testing is not recommended for patients undergoing cataract surgery, Catherine L. Chen, MD, MPH, from the University of California in San Francisco, and colleagues examined adherence to this guideline. They determined the prevalence and cost of preoperative testing in the month before surgery using an observational cohort of Medicare beneficiaries undergoing cataract surgery in 2011. The prevalence of preoperative testing and office visits was compared with the mean percentage of beneficiaries who underwent tests and had office visits in the previous 11 months.
The researchers found that 53% of 440,857 patients had at least one preoperative test in the month preceding cataract surgery. Compared with the mean monthly expenditures for the preceding 11 months, during the month before surgery, expenditures on testing and office visits were $4.8 million and $12.4 million higher, respectively (42 and 78% higher, respectively). Among ophthalmologists there was wide variation in testing, with 36% of ophthalmologists ordering preoperative tests for more than 75% of their patients. The probability of undergoing testing was mainly linked to the ophthalmologist who managed the preoperative assessment.
"Preoperative testing before cataract surgery occurred frequently and was more strongly associated with provider practice patterns than with patient characteristics," the authors write.