Preoperative Medical Testing in Medicare Patients Undergoing Cataract Surgery
Routine preoperative testing is not recommended before cataract surgery. In this analysis of Medicare claims data, preoperative testing was common and varied widely among ophthalmologists; the ophthalmologist performing the surgery was the strongest predictor of testing. Cataract surgery is the most...
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| Veröffentlicht in: | The New England journal of medicine 2015-04, Vol.372 (16), p.1530-1538 |
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| container_title | The New England journal of medicine |
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| creator | Chen, Catherine L Lin, Grace A Bardach, Naomi S Clay, Theodore H Boscardin, W. John Gelb, Adrian W Maze, Mervyn Gropper, Michael A Dudley, R. Adams |
| description | Routine preoperative testing is not recommended before cataract surgery. In this analysis of Medicare claims data, preoperative testing was common and varied widely among ophthalmologists; the ophthalmologist performing the surgery was the strongest predictor of testing.
Cataract surgery is the most common elective surgery among Medicare beneficiaries, with 1.7 million procedures performed annually.
1
It is also very safe, with less than a 1% risk of major adverse cardiac events or death.
2
The mean duration of cataract surgery is 18 minutes,
3
and virtually all surgical procedures are performed in an ambulatory setting with topical anesthesia.
4
However, because patients are typically elderly with multiple coexisting conditions,
5
,
6
physicians frequently order routine preoperative tests because of concerns about patient safety, worries about medicolegal risks, and the perception that other physicians expect preoperative testing.
6
,
7
Despite these common justifications, previous . . . |
| doi_str_mv | 10.1056/NEJMsa1410846 |
| format | Article |
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Cataract surgery is the most common elective surgery among Medicare beneficiaries, with 1.7 million procedures performed annually.
1
It is also very safe, with less than a 1% risk of major adverse cardiac events or death.
2
The mean duration of cataract surgery is 18 minutes,
3
and virtually all surgical procedures are performed in an ambulatory setting with topical anesthesia.
4
However, because patients are typically elderly with multiple coexisting conditions,
5
,
6
physicians frequently order routine preoperative tests because of concerns about patient safety, worries about medicolegal risks, and the perception that other physicians expect preoperative testing.
6
,
7
Despite these common justifications, previous . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMsa1410846</identifier><identifier>PMID: 25875258</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Aged ; Anesthesia ; Cataract Extraction ; Cataracts ; Diagnostic Tests, Routine - economics ; Diagnostic Tests, Routine - statistics & numerical data ; Eye surgery ; Female ; Guideline Adherence ; Health Care Costs ; Humans ; Male ; Medical tests ; Medicare ; Office Visits - statistics & numerical data ; Ophthalmology ; Practice Patterns, Physicians' - statistics & numerical data ; Preoperative Care - economics ; Preoperative Care - statistics & numerical data ; Surgery ; United States ; Unnecessary Procedures - economics ; Unnecessary Procedures - statistics & numerical data</subject><ispartof>The New England journal of medicine, 2015-04, Vol.372 (16), p.1530-1538</ispartof><rights>Copyright © 2015 Massachusetts Medical Society. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a534t-d78d60ac6192aa08c85d18cd05605969a21abbcd49c1639ba201234330d649143</citedby><cites>FETCH-LOGICAL-a534t-d78d60ac6192aa08c85d18cd05605969a21abbcd49c1639ba201234330d649143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMsa1410846$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.nejm.org/doi/full/10.1056/NEJMsa1410846$$EHTML$$P50$$Gmms$$H</linktohtml><link.rule.ids>230,314,776,780,881,2746,2747,26080,27901,27902,52357,54039</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25875258$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Catherine L</creatorcontrib><creatorcontrib>Lin, Grace A</creatorcontrib><creatorcontrib>Bardach, Naomi S</creatorcontrib><creatorcontrib>Clay, Theodore H</creatorcontrib><creatorcontrib>Boscardin, W. John</creatorcontrib><creatorcontrib>Gelb, Adrian W</creatorcontrib><creatorcontrib>Maze, Mervyn</creatorcontrib><creatorcontrib>Gropper, Michael A</creatorcontrib><creatorcontrib>Dudley, R. Adams</creatorcontrib><title>Preoperative Medical Testing in Medicare Patients Undergoing Cataract Surgery</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>Routine preoperative testing is not recommended before cataract surgery. In this analysis of Medicare claims data, preoperative testing was common and varied widely among ophthalmologists; the ophthalmologist performing the surgery was the strongest predictor of testing.
Cataract surgery is the most common elective surgery among Medicare beneficiaries, with 1.7 million procedures performed annually.
1
It is also very safe, with less than a 1% risk of major adverse cardiac events or death.
2
The mean duration of cataract surgery is 18 minutes,
3
and virtually all surgical procedures are performed in an ambulatory setting with topical anesthesia.
4
However, because patients are typically elderly with multiple coexisting conditions,
5
,
6
physicians frequently order routine preoperative tests because of concerns about patient safety, worries about medicolegal risks, and the perception that other physicians expect preoperative testing.
6
,
7
Despite these common justifications, previous . . .</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Cataract Extraction</subject><subject>Cataracts</subject><subject>Diagnostic Tests, Routine - economics</subject><subject>Diagnostic Tests, Routine - statistics & numerical data</subject><subject>Eye surgery</subject><subject>Female</subject><subject>Guideline Adherence</subject><subject>Health Care Costs</subject><subject>Humans</subject><subject>Male</subject><subject>Medical tests</subject><subject>Medicare</subject><subject>Office Visits - statistics & numerical data</subject><subject>Ophthalmology</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Preoperative Care - economics</subject><subject>Preoperative Care - statistics & numerical data</subject><subject>Surgery</subject><subject>United States</subject><subject>Unnecessary Procedures - economics</subject><subject>Unnecessary Procedures - statistics & numerical data</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kUtLAzEUhYMotlaXbmVABDejyeTRzEaQUl9YLdiuw22S1inzqMlMof_elNZiBe8iF3I_Tu7JQeic4BuCubh9678MPBBGsGTiALUJpzRmDItD1MY4kTHrprSFTryf41CEpceolXDZ5eFoo8HQ2WphHdTZ0kYDazINeTSyvs7KWZSV2ytno2FAbFn7aFwa62bVet6DGhzoOvpo3My61Sk6mkLu7dm2d9D4oT_qPcWv74_PvfvXGDhldWy60ggMWpA0AcBSS26I1Cb4wTwVKSQEJhNtWKqJoOkEEkwSyijFRrCUMNpBdxvdRTMprNFhLwe5WrisALdSFWRqf1Jmn2pWLRXnVJDwIR10vRVw1VcT3Koi89rmOZS2arwiossSzIRcv3X5B51XjSuDvTVFJWeJFIGKN5R2lffOTnfLEKzWQam9oAJ_8dvBjv5JJgBXG6AovCrtvPhH6BustJlc</recordid><startdate>20150416</startdate><enddate>20150416</enddate><creator>Chen, Catherine L</creator><creator>Lin, Grace A</creator><creator>Bardach, Naomi S</creator><creator>Clay, Theodore H</creator><creator>Boscardin, W. John</creator><creator>Gelb, Adrian W</creator><creator>Maze, Mervyn</creator><creator>Gropper, Michael A</creator><creator>Dudley, R. 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John ; Gelb, Adrian W ; Maze, Mervyn ; Gropper, Michael A ; Dudley, R. Adams</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a534t-d78d60ac6192aa08c85d18cd05605969a21abbcd49c1639ba201234330d649143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Cataract Extraction</topic><topic>Cataracts</topic><topic>Diagnostic Tests, Routine - economics</topic><topic>Diagnostic Tests, Routine - statistics & numerical data</topic><topic>Eye surgery</topic><topic>Female</topic><topic>Guideline Adherence</topic><topic>Health Care Costs</topic><topic>Humans</topic><topic>Male</topic><topic>Medical tests</topic><topic>Medicare</topic><topic>Office Visits - statistics & numerical data</topic><topic>Ophthalmology</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Preoperative Care - economics</topic><topic>Preoperative Care - statistics & numerical data</topic><topic>Surgery</topic><topic>United States</topic><topic>Unnecessary Procedures - economics</topic><topic>Unnecessary Procedures - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Catherine L</creatorcontrib><creatorcontrib>Lin, Grace A</creatorcontrib><creatorcontrib>Bardach, Naomi S</creatorcontrib><creatorcontrib>Clay, Theodore H</creatorcontrib><creatorcontrib>Boscardin, W. 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Cataract surgery is the most common elective surgery among Medicare beneficiaries, with 1.7 million procedures performed annually.
1
It is also very safe, with less than a 1% risk of major adverse cardiac events or death.
2
The mean duration of cataract surgery is 18 minutes,
3
and virtually all surgical procedures are performed in an ambulatory setting with topical anesthesia.
4
However, because patients are typically elderly with multiple coexisting conditions,
5
,
6
physicians frequently order routine preoperative tests because of concerns about patient safety, worries about medicolegal risks, and the perception that other physicians expect preoperative testing.
6
,
7
Despite these common justifications, previous . . .</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>25875258</pmid><doi>10.1056/NEJMsa1410846</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 2015-04, Vol.372 (16), p.1530-1538 |
| issn | 0028-4793 1533-4406 |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; New England Journal of Medicine Current |
| subjects | Aged Anesthesia Cataract Extraction Cataracts Diagnostic Tests, Routine - economics Diagnostic Tests, Routine - statistics & numerical data Eye surgery Female Guideline Adherence Health Care Costs Humans Male Medical tests Medicare Office Visits - statistics & numerical data Ophthalmology Practice Patterns, Physicians' - statistics & numerical data Preoperative Care - economics Preoperative Care - statistics & numerical data Surgery United States Unnecessary Procedures - economics Unnecessary Procedures - statistics & numerical data |
| title | Preoperative Medical Testing in Medicare Patients Undergoing Cataract Surgery |
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