COST-EFFECTIVENESS OF A SINGLE-FUNCTION TREATMENT CENTER FOR CATARACT-SURGERY

Purpose: To compare the clinical and cost effectiveness of two models for cataract treatment: a single-function Cataract Treatment Centre (C TC) and a general ophthalmology service. Setting: Cataract Treatment C entre and the general ophthalmology service at Sunderland Eye Infirmar y, Sunderland, United Kingdom. Methods: Two hundred patients were stud ied using two models of care: 100 in the CTC and 100 in the general op hthalmotogy service. Outcome measures were best corrected visual acuit y at 3 months postoperatively or at discharge and occurrence of surger y-related complications. All direct costs to the National Health Servi ce were identified, measured, and assessed. Results: Clinical outcomes in the two groups were similar. The average cost per patient was poun d 496.90 ($760.25) at the CTC and pound 566.34 ($866.50) at the genera l ophthalmotogy service. The cost per patient treated as a day case in the general service group was pound 495.84 ($758.63). Thus, treatment at the CTC was more cost effective than in the mixed service group an d as cost effective as in the day case subgroup. Conclusions: Dependin g on local circumstances, day care may be delivered more cost effectiv ely in a single-function center than in a general ophthalmology servic e. We recommend day care using local anesthesia and protocols for asse ssment, surgery, and follow-up.