Elimination of routine testing in patients undergoing cataract surgery allows substantial savings in laboratory costs. A brief report.
OBJECTIVE
To evaluate the possible cost savings when routine preoperative testing is discontinued in ambulatory cataract surgery patients.


METHODS
A policy was introduced at our hospital to stop routine testing in ambulatory cataract patients. Consecutive patients' medical records were analyzed in a four-month period pre- and a four-month period post-discontinuation of routine laboratory tests. Ambulatory cataract surgery is performed under topical (and sometimes retrobulbar block) anesthesia with iv sedation. Co-morbidities, perioperative events, frequency and cost of tests ordered were compared for the two groups. Average costs per patient pre- and post-discontinuation of routine tests, and total possible cost savings were calculated.


RESULTS
One thousand two hundred and thirty-one patients were studied; 636 had routine laboratory tests and 595 had no routine laboratory tests. The ratios of gender, co-morbidities and perioperative events were similar in the two groups. There was a significant reduction in the number of tests ordered after the new policy was introduced, from 5.8 tests per patient to 0.4 tests per patient. The cost of tests per patient was reduced from Can $39.67 to $4.01.


CONCLUSIONS
In ambulatory cataract surgery, over 90% savings in laboratory costs is possible after elimination of routine tests.
Imasogie
Ngozi
N
Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada.
Wong
David T
DT
Luk
Ken
K
Chung
Frances
F
D000556:Ambulatory Surgical Procedures; D002387:Cataract Extraction; D017046:Cost Savings; D003955:Diagnostic Tests, Routine / Q000191:economics*; D006801:Humans