Preoperative consultations for medicare patients undergoing cataract surgery

JAMA Internal Medicine
Stephan R ThilenDuminda N Wijeysundera

Abstract

Low-risk elective surgical procedures are common, but there are no clear guidelines for when preoperative consultations are required. Such consultations may therefore represent a substantial discretionary service. To assess temporal trends, explanatory factors, and geographic variation for preoperative consultation in Medicare beneficiaries undergoing cataract surgery, a common low-risk elective procedure. Cohort study using a 5% national random sample of Medicare part B claims data including a cohort of 556,637 patients 66 years or older who underwent cataract surgery from 1995 to 2006. Temporal trends in consultations were evaluated within this entire cohort, whereas explanatory factors and geographic variation were evaluated within the 89,817 individuals who underwent surgery from 2005 to 2006. Separately billed preoperative consultations (performed by family practitioners, general internists, pulmonologists, endocrinologists, cardiologists, nurse practitioners, or anesthesiologists) within 42 days before index surgery. The frequency of preoperative consultations increased from 11.3% in 1998 to 18.4% in 2006. Among individuals who underwent surgery in 2005 to 2006, hierarchical logistic regression modeling found several fact...Continue Reading

Citations

Oct 17, 2014·Current Opinion in Anaesthesiology·Lucia Aurini, Paul F White
Apr 16, 2015·The New England Journal of Medicine·Catherine L ChenR Adams Dudley
Feb 20, 2015·Anesthesia and Analgesia·Duminda N Wijeysundera, W Scott Beattie
Mar 2, 2016·Anesthesiology Clinics·Matthias BockDavid L Hepner
Mar 2, 2016·Anesthesiology Clinics·Stephan R ThilenMiriam M Treggiari
Jan 25, 2017·Current Opinion in Anaesthesiology·Jean Marty, Emmanuel Samain
Apr 30, 2020·Journal of Cataract and Refractive Surgery·Elaine M TranPaul B Greenberg
Mar 23, 2017·Journal of General Internal Medicine·Oliver D Schein, Peter J Pronovost
May 15, 2018·Perioperative Medicine·Stephan R ThilenMiriam M Treggiari
Nov 17, 2021·Anesthesia and Analgesia·BobbieJean SweitzerGirish P Joshi
Jul 1, 2021·Journal of Evaluation in Clinical Practice·Joanna M M DionJason A Beyea

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