Comparison of complication rates in veterans receiving cataract surgery through the Veterans Health Administration and Medicare.
Med Care
; 50(7): 620-6, 2012 Jul.
Article
en En
| MEDLINE
| ID: mdl-22410409
BACKGROUND: To compare the 90-day rates of select secondary procedures after cataract extraction in patients having fee-for-service surgery under Medicare to surgeries provided through the Veterans Health Administration (VHA) during the same calendar year. METHODS: Medicare, VHA, and VHA Fee Basis Program data for calendar year 2007 were merged to identify a cohort of veterans that had outpatient cataract surgery. Secondary surgeries were tracked using selected Current Procedural Terminology (CPT) codes as surrogate markers for complications. Primary surgery and corrective surgeries were linked through right and left eye CPT modifier codes. Risks of complications were adjusted for race, age, sex, and ocular and medical comorbidities. RESULTS: A total of 223,873 cataract extractions were performed on veterans during calendar year 2007, 88.4% of which were provided through Medicare. The 90-day overall rate of CPT-coded secondary procedures was greater for patients having cataract surgery through the VHA (37.2 per 1000 surgeries) than Medicare (18.2 per 1000 surgeries). The overall rate was influenced primarily by higher rates of vitrectomy and related procedures, after both routine and complex cataract extractions. The adjusted odds ratio of vitrectomy within 90 days of routine cataract surgery in the VHA with reference to Medicare was 3.77 (95% confidence interval, 3.44-4.14). CONCLUSIONS: In 2007, the pattern and rates of secondary surgeries after cataract extraction varied between the Medicare and the VHA programs. If these results are confirmed, further research to identify the sources of higher secondary procedure rates is warranted to enhance patient safety.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Extracción de Catarata
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Medicare
/
United States Department of Veterans Affairs
Tipo de estudio:
Etiology_studies
/
Incidence_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Med Care
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos