title: Phacoemulsification versus extracapsular extraction: governmental costs.
abstract: To evaluate the governmental costs of patients undergoing phacoemulsification and extracapsular cataract extraction at a public hospital in a developing country.
  
  
  
  A prospective study was conduced with 205 patients. The subjects were randomized for cataract surgery using either phacoemulsification or extracapsular cataract extraction techniques.
  
  
  
  Of the 205 patients, 101 patients were submitted to phacoemulsificationand 104 patients were submitted to extracapsular cataract extraction. Brazilian Health Care System expenditures for the surgery and the postoperative period were US$ 95.49 more in the phacoemulsification group than in the extracapsular cataract extractiongroup. If we take into account Social Security expenditures, then we estimate that the average difference for the total direct cost for the government for the surgery and the postoperative period for both procedures was US$ 50.91 or approximately half of the initial difference in cost for the phacoemulsification surgery. The total cost of cataract surgery for the government (excluding social security) was estimated at US$ 258.79 for extracapsular cataract extraction and US$ 309.70 for phacoemulsification per patient. Focusing only on working patients, the total cost was US$ 342.21 for phacoemulsification and US$ 587.71 for extracapsular cataract extraction, a difference of US$ 245.50. This difference can be considered monetarily and socially justifiable when the benefits of the surgical technique are evaluated.
  
  
  
  Under the conditions of this study, we observed that phacoemulsification was an efficient procedure with regard to the impact on public health care system, when all costs are assessed comprehensively, mainly for subjects with regular jobs.
authors.affiliation: Ophthalmology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. maysa_mazurek@hotmail.com
authors.forename: Newton
authors.initials: N
authors.lastname: Kara
authors.forename: Maysa Godoy Gomes Mazurek
authors.initials: MG
authors.lastname: Sirtoli
authors.forename: Marcony Rodrigues
authors.initials: MR
authors.lastname: Santhiago
authors.forename: Tais Renata Ribeira
authors.initials: TR
authors.lastname: Parede
authors.forename: Rodrigo França de
authors.initials: RF
authors.lastname: Espíndola
authors.forename: Regina de Souza
authors.initials: Rde S
authors.lastname: Carvalho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002387:Cataract Extraction / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D003906:Developing Countries; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000191:economics / Q000706:statistics & numerical data; D011446:Prospective Studies; D018709:Statistics, Nonparametric
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