Evaluation of costs for cystoid macular edema among patients after cataract surgery.
OBJECTIVE
Little is known about the costs of cystoid macular edema (CME), an important complication associated with cataract surgery. The purpose of this analysis was to estimate the cost of treatment for CME in the United States.


METHODS
Data were analyzed from the 1997 through 2001 Medicare 5% Beneficiary Encrypted Files. Beneficiaries who underwent cataract surgery were identified and stratified by diagnosis of CME (cases) or no diagnosis of CME (controls) within 1 year after surgery. Claims and reimbursements for ophthalmic care were identified. Subgroup analyses explored CME costs among beneficiaries with diabetes versus those without diabetes.


RESULTS
Of 139,759 beneficiaries with cataract surgery, 1.95% (2,720) were diagnosed with CME. Annual total ophthalmic claims were 41% ($3,298) higher for cases than for controls; payments were 47% ($1,092) higher (both P < 0.0001). Approximately 16% (23,122) of cataract patients had diabetes. The rate of CME diagnosis was significantly higher for diabetics than for nondiabetics (3.05% vs. 1.73%, respectively). Differences in claims and payments between cases and controls were similar for diabetic and nondiabetic subgroups.


CONCLUSIONS
CME is associated with substantial costs. Therapies that prevent or decrease CME severity are likely to result in cost savings, particularly among diabetic beneficiaries. Further analyses should explore the relationship of comorbidities to costs among CME patients.
Schmier
Jordana K
JK
Exponent Inc., 1800 Diagonal Road, Alexandria, VA 22314, USA. jschmier@exponent.com
Halpern
Michael T
MT
Covert
David W
DW
Matthews
G Philip
GP
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects*; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D048909:Diabetes Complications; D004470:Economics, Medical; D005260:Female; D017048:Health Care Costs; D006302:Health Services Research; D006801:Humans; D007345:Insurance Claim Review / Q000191:economics*; D008269:Macular Edema / Q000175:diagnosis / Q000191:economics* / Q000209:etiology; D008297:Male; D006278:Medicare / Q000191:economics*; D011183:Postoperative Complications; D014481:United States