PMD32 Combining Healthcare Solutions for Cataract Surgery. an Incremental Benefit Analysis from the Perspective of the Danish Healthcare System.

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 a total cost of ownership (TCO) solution for cataract surgery, from the perspective of the Danish healthcare system. A decision-analytic model was developed analyzing the aggregated impact of a combination of products/services for cataract surgery: monofocal/toric intraocular lenses (IOL), IOL delivery-system, process-redesign, phacoemulsification machine and tip. The model and underlying assumptions were validated by clinical experts. The following variables of efficiency underpinned the analysis: OR time-savings, posterior capsule opacification (PCO) and IOL repositioning rates. 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 1,623,846 DKK per year, with 68 cases of PCO treatment and 1 IOL repositioning surgery avoided, and generated time-savings equivalent to approximately 298 cataract procedures and 203 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 hospitals and payers.