Routine Preoperative Medical Testing Overuse Linked With Delayed Cataract Surgery and Increase Patient Falls in Medicare Beneficiaries
The overuse of routine preoperative medical testing by high-testing doctors is associated with postponement of cataract surgery and increased falls in patients waiting to undergo the procedure, reported Ophthalmology.1
Specifically, more patients who were managed by high-testing doctors waited ≥30 days and ≥90 days to undergo cataract surgery (31.4% and 8.2% vs. 25.0% and 5.5%, respectively; P<0.0001 for both), and falls prior to surgery in these patients increased by 43% within 90 days after ocular biometry (1.0% vs. 0.7%; P<0.0001). Additionally, the adjusted odds ratio of patients managed by high-testing doctors falling within 90 days of undergoing biometry was 1.10 (95% confidence interval [CI], 1.03-1.19; P=0.008) vs. patients managed by low-testing doctors. Further, after compensating for surgery wait time, this odds ratio reduced to 1.07 (95% CI, 1.00-1.15; P=0.06).
The surgical delay linked with having a high-testing doctor was approximately 8 days (estimate, 7.97 days; 95% CI, 6.40 to 9.55 days; P<0.0001). Other factors linked with surgical postponement were patient race (non-White), Northeast region, ophthalmologist ≤40 years of age, and low surgical volume.
The study was comprised of 248,345 beneficiaries, 16.4% of whom were managed by high-testing doctors.