(HealthDay News) – The frequency of preoperative consultations for cataract surgery has increased substantially, even though there are no national guidelines specifying when a referral is needed, according to a study published online Dec. 23 in JAMA Internal Medicine.

Stephan R. Thilen, MD, from the University of Washington in Seattle, and colleagues analyzed claims data from 556,637 patients >66 years who underwent cataract surgery from 1995–2006. The authors sought to assess trends in the frequency of preoperative consultations up to 42 days before surgery. Data from a subset of 89,817 patients were used to assess explanatory factors and geographic variation.

The researchers found that the frequency of consultations increased to 18.4% in 2006 from 11.3% in 1998. Factors associated with preoperative consultation included age, race, urban versus rural residence, facility type, anesthesia provider, and geographic region. There was substantial variation in the frequency of consultation across hospital referral regions, even after taking other factors into account.

“Between 1995 and 2006, the frequency of preoperative consultation for cataract surgery increased substantially,” Thilen and colleagues conclude. “These data highlight an area of opportunity for interventions aimed at reducing unwanted practice variability in a process that has the potential to consume vast amounts of health care resources.”

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