Impact of Phacoemulsification Equipment in Surgical Throughput, Under the Perspective of a Greek Hospital

OBJECTIVES: Increased cost of healthcare is a common challenge which most countries face. The Greek government strives to ensure universal coverage and equitable access, focusing on cost containment policies and increased efficiencies. Cataract surgery is one of the most frequent surgical procedures at country level and phacoemulsification is the preferred technique. The objective of this analysis is to estimate the economic impact and efficiency of different phacoemulsification equipment, under the perspective of a Greek hospital.

METHODS: A decision-analytic model was developed to analyze the aggregated impact on cataract surgery throughput of different phacoemulsification equipment features. Scenario 1 vs scenario 2 considered phacoemulsification equipment with the following variables: torsional vs longitudinal ultrasound movement (TvL), Active Sentry^TM vs. other handpiece (ASvO), active fluidics vs gravity-based infusion system (AFvGB) and Intrepid vs. Kelman phaco tip (IvK). Inputs were derived from the literature (one study per variable) and expert opinion. The model and underlying assumptions were validated by clinical experts. OR time was chosen as the key variable of efficiency. The model assumed a hospital performing 2,000 cataract procedures per-annum (grade 3 and 4 cataracts), with 100% adoption and equal acquisition costs for each one of the two scenarios.

RESULTS: Savings in OR time (seconds) were estimated as 62 for TvL, 12.10 for ASvO, 41.71 for AFvGB, and 17.64 for IvK, accounting for 11% efficiency increase for the cataract procedure time between the two scenarios of the analysis. This could translate into an annual difference of 63,611€.

CONCLUSIONS: This analysis highlights the relevance of phacoemulsification features such as ultrasound movement, handpiece, infusion system and phaco-tip, with the aim to achieve an efficient throughput for cataract surgery, with subsequent cost-savings for the hospital. Further research would be needed, to better estimate the contribution of phacoemulsification equipment for efficient cataract surgeries.