PMD26 Combining Healthcare Solutions for Cataract Surgery. an Incremental Benefit Analysis from the Perspective of an Italian Public Hospital.

Abstract

Rising health expenditures lead to increasing budgetary pressures, which often manifest into budget holders seeking more to be done with the same resources or indeed, the same done with less. As such, enablers to drive efficiencies throughout the healthcare system have come under increasing focus. No more so than in the operating room (OR), where considerations around operational efficiency, clinical excellence, and patient-centricity pose challenging questions. While a comprehensive solution set should be formulated as a strategy plan, small parts of the solution can be applied, keeping systems open and interoperable to easily integrate future solutions The objective of this analysis is to estimate the impact of combining custom healthcare solutions for cataract surgery, from the perspective of an Italian public hospital. A decision-analytic model was developed analyzing the aggregated impact of combining four technologies for cataract surgery: intraocular lens (IOL), IOL delivery-system, phacoemulsification machine and tip. The model and underlying assumptions were validated by clinical experts. The following variables of efficiency underpinned the analysis: posterior capsule opacification/rupture (PCO & PCR) rates, OR time-savings and consultant visits. Inputs were estimated from the literature and local cost databases. Two scenarios were defined, reflecting technologies which are commonly used in surgical practice. The model scenarios assumed a hospital performs 2,500 cataract procedures per-year, with 100% adoption and equal acquisition costs. The choice of healthcare solution combination, resulted in an incremental benefit of 47,402€ per year, with 68 cases of PCO treatment and 12 of PCR avoided, and generated time-savings equivalent to approximately 272 cataract procedures and 242 consultant visits. This analysis highlights that compared to treating technologies on an individual level, combining healthcare solutions commonly used for cataract surgery, has the potential to improve outcomes for patients while driving efficiencies and cost-savings for public hospitals.