CC-BY-NC-ND 4.0 · J Acad Ophthalmol 2018; 10(01): e1-e4
DOI: 10.1055/s-0037-1620236
Research Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cataract Surgery Cancellations: An Analysis of Financial and Resident Training Implications at a Major Eye Institution

Sneha Padidam
1  Kresge Eye Institute, Detroit, Michigan
,
Douglas Wisner
2  Cataract and Primary Eye Care Service, Wills Eye Hospital, Philadelphia, Pennsylvania
,
Brianna Kenney
3  Department of Research, Wills Eye Hospital, Philadelphia, Pennsylvania
,
Jared Peterson
2  Cataract and Primary Eye Care Service, Wills Eye Hospital, Philadelphia, Pennsylvania
,
Laura Pizzi
4  College of Pharmacy, Thomas Jefferson University, Philadelphia, Pennsylvania
,
Benjamin E. Leiby
5  Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, Pennsylvania
,
Lisa Hark
6  Department of Ophthalmology, Columbia University Medical Center, New York, New York
,
Robert Bailey
2  Cataract and Primary Eye Care Service, Wills Eye Hospital, Philadelphia, Pennsylvania
,
the Wills Cataract Research Group› Author Affiliations
Further Information

Publication History

14 January 2016

30 November 2017

Publication Date:
22 January 2018 (online)

Abstract

Purpose The objective of this study was to assess reasons for cancellation of resident-performed cataract surgery, identify modifiable barriers to completion of the surgery on the scheduled date, and analyze the healthcare reimbursements and educational experiences lost as a result of cancellations.

Setting General eye clinic staffed by residents in a major urban center.

Design Retrospective, observational study.

Methods The study compared patients (older than 18 years) who canceled their cataract surgery to patients who underwent surgery on their scheduled date. Cancellation and reimbursement information was obtained from the surgical coordinator's scheduling book and billing information. Demographic information was obtained from patient electronic medical records, and scheduling logs. A brief phone survey was implemented to identify patient's barriers to surgery if a reason for cancellation was undocumented.

Results The overall cancellation rate over 1-year was 29.54% and most common overall reason for cancellation was that preadmission testing (PAT) was not completed in time for the procedure. Overall, 72% of the cancellations were made within 7 days of the surgery. The total estimated lost potential reimbursement due to cancellation was $844,370. The relative loss of surgical opportunities for residents throughout this 1-year period was 230 cases or 29 surgeries per resident.

Conclusion These findings have prompted a new study testing whether on-site mandatory PATs conducted on the same day as the patient's ophthalmology evaluation will reduce cataract surgery cancellation rates.

Authors' Contributions

Sneha Padidam: Acquisition, analysis, and interpretation of data; drafting of the manuscript; and administrative, technical, or material support.


Douglas Wisner: Conception and design of the study; acquisition, analysis, and interpretation of data; drafting of the manuscript; statistical analysis; critical revision of the manuscript; obtaining funding; administrative, technical, and material support; and supervision of the study.


Brianna Kenney: Conception and design of the study, drafting of the manuscript, obtaining funding, and supervision of the study.


Jared Peterson: Conception and design of the study; acquisition, analysis, and interpretation of data; critical revision of the manuscript; obtaining funding; administrative, technical, and material support; and supervision of the study.


Laura Pizzi: Conception and design of the study; acquisition, analysis, and interpretation of data; statistical analysis; drafting and critical revision of the manuscript; and administrative, technical, or material support.


Benjamin E. Leiby: Analysis and interpretation of data, critical revision of the manuscript, and statistical analysis.


Robert Bailey: Conception and design of the study; acquisition, analysis, and interpretation of data; critical revision of the manuscript; obtaining funding; administrative, technical, and material support; and supervision of the study.


Wills Cataract Research Group: Conception and design of the study; acquisition, analysis, and interpretation of data; statistical analysis; drafting and critical revision of the manuscript; administrative, technical, or material support; obtaining funding; administrative, technical, and material support; and supervision of the study.


Funding Source

Wills Eye Innovation Research Grant (grant number: INV #12–025). The funder had no role in the following: design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.