A cost and policy analysis comparing immediate sequential cataract surgery and delayed sequential cataract surgery from the physician perspective in the United States.
A cost and policy analysis comparing immediate sequential cataract surgery and delayed sequential cataract surgery from the physician perspective in the United States.
复制标题
从美国医生的角度比较立即序贯白内障手术和延迟序贯白内障手术的成本和政策分析。
DOI：
10.1001/jamaophthalmol.2014.3335
复制
发表时间：
2014
影响因子：
8.1
通讯作者：
S. Neel
中科院分区：
文献类型：
--
作者：
S. Neel
重要性
进行了成本分析，以评估从延迟序贯白内障手术过渡到立即序贯白内障手术对美国医生的影响。对这一变化的财务和效率影响进行了评估，以确定效率提高是否可以抵消潜在的收入减少。
观察
一项使用Medicare白内障手术量估计、Medicare 2012医生白内障手术报销时间表和潜在额外办公室访问收入估计的成本分析，比较了田纳西州西部单一眼科专科诊所的立即序贯白内障手术和延迟序贯白内障手术。这一模式应该给出全国范围内对医生的影响的指示。西田纳西州一家眼科专科诊所被发现白内障手术收入损失12.6万美元，出诊收入增加34 449美元至106 271美元(最小和最大抵销法)，转为立即序贯白内障手术后净亏损19 900美元至91 700美元(基本情况)。
结论和相关性
医生可能会在经济上蒙受损失，在目前的报销制度下，这种损失不能通过增加患者就诊次数来抵消。这可能会导致医生抵制转向立即顺序白内障手术、游戏和供应商诱导的需求。
IMPORTANCE
A cost analysis was performed to evaluate the effect on physicians in the United States of a transition from delayed sequential cataract surgery to immediate sequential cataract surgery. Financial and efficiency impacts of this change were evaluated to determine whether efficiency gains could offset potential reduced revenue.
OBSERVATIONS
A cost analysis using Medicare cataract surgery volume estimates, Medicare 2012 physician cataract surgery reimbursement schedules, and estimates of potential additional office visit revenue comparing immediate sequential cataract surgery with delayed sequential cataract surgery for a single specialty ophthalmology practice in West Tennessee. This model should give an indication of the effect on physicians on a national basis. A single specialty ophthalmology practice in West Tennessee was found to have a cataract surgery revenue loss of $126,000, increased revenue from office visits of $34,449 to $106,271 (minimum and maximum offset methods), and a net loss of $19,900 to $91,700 (base case) with the conversion to immediate sequential cataract surgery.
CONCLUSIONS AND RELEVANCE
Physicians likely stand to lose financially, and this loss cannot be offset by increased patient visits under the current reimbursement system. This may result in physician resistance to converting to immediate sequential cataract surgery, gaming, and supplier-induced demand.