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From:
Health at a Glance 2011OECD Indicators
Access the complete publication at:
http://dx.doi.org/10.1787/health_glance-2011-en
Cataract surgeries
Please cite this chapter as:
OECD (2011), Cataract surgeries, in Health at a Glance 2011:
OECD Indicators, OECD Publishing.
http://dx.doi.org/10.1787/health_glance-2011-38-en
http://dx.doi.org/10.1787/health_glance-2011-38-enhttp://dx.doi.org/10.1787/health_glance-2011-en -
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This document and any map included herein are without prejudice to the status of orsovereignty over any territory, to the delimitation of international frontiers and boundaries and to
the name of any territory, city or area.
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4. HEALTH CARE ACTIVITIES
HEALTH AT A GLANCE 2011: OECD INDICATORS OECD 201198
4.10. Cataract surgeries
In the past two decades, the number of surgical procedures
carried out on a same-day basis, without any need for hos-
pitalisation, has grown in most OECD countries. Advances
in medical technologies, particularly the diffusion of less
invasive surgical interventions, and better anaesthetics
have made this development possible. These innovations
have also improved patient safety and health outcomes forpatients, and have in many cases helped to reduce the unit
cost per intervention by shortening the length of stay in
hospitals. However, the impact of the rise in same-day
surgeries on health spending depends not only on changes
in their unit cost, but also on the growth in the sheer
number of procedures performed, and needs to take into
account any additional cost related to post-acute care and
community health services.
Cataract surgery provides a good example of a high-volume
surgery which is now carried out predominantly on a
same-day basis in most OECD countries. Day surgery now
accounts for over 90% of all cataract surgeries in a majority
of countries (Figure 4.10.1). However, the use of day surgeryis still relatively low in some countries, such as Poland, the
Slovak Republic and Hungary. This may be explained by
more advantageous reimbursement for inpatient stays,
national regulations, and obstacles to changing individual
practices of surgeons and anaesthetists (Castoro et al.,
2007), but these low rates may also reflect limitations in
data coverage (the lack of registration of day surgeries
carried outside hospitals in Poland).
The number of cataract surgeries performed on a same-day
basis has grown very rapidly over the past decade in many
countries. In France, the share rose from 32% in 2000 to 78%
in 2009. In Portugal, it has grown at a rate of over 50% per
year since 2000 (Figure 4.10.2). Whereas less than 10% ofcataract surgeries in Portugal were performed on a same-
day basis in 2000, this proportion increased to 92% in 2009.
In Luxembourg also, the number of cataract surgeries
carried out as day cases has risen rapidly over the past
decade, although they still account for only one-quarter of
all cataract surgeries. In Norway, the growth in cataract
surgeries performed as day cases since 2000 substituted for
some that previously required hospitalisation; the overall
number of procedures remained constant, but the share of
day case surgeries increased from 87% to 97%.
The total number of cataract surgeries has also grown
substantially over the past decade, so that it has now
become the most frequent surgical procedure in many
OECD countries. Population ageing is one of the factors
behind this rise, but the proven success, safety and cost-
effectiveness of cataract surgery as a day procedure has
been a more important factor (Fedorowicz et al., 2004). InSweden, there is evidence that cataract surgeries are now
being performed on patients suffering from less severe
vision problems compared to ten years ago. This raises the
question of how the needs of these patients should be
prioritised relative to other patient groups (Swedish
Association of Local Authorities and Regions and National
Board of Health and Welfare, 2010).
Definition and comparability
Cataract surgeries consist of removing the lens of the
eye because of the presence of cataracts and replacing
it with an artificial lens. The surgery may be carried
out as a day case or as an inpatient case (involving an
overnight stay in hospital). Although same-day inter-
ventions may either be performed in a hospital or in a
clinic, the data for many countries (e.g. Ireland,
Hungary, the Netherlands, Poland) only include inter-
ventions carried out in hospitals. Caution is therefore
required in making cross-country comparisons, given
the different coverage of day surgeries in several
countries.
The data for Denmark only include cataract surgeriescarried out in public hospitals, excluding procedures
carried out in the ambulatory sector and in private
hospitals. In Ireland too, the data cover only proce-
dures in public hospitals. It is estimated that over
10% of all hospital activity in Ireland is undertaken in
private hospitals. The data for Spain only partially
include the activities in private hospitals.
Information on data for Israel: http://dx.doi.org/10.1787/
888932315602.
http://-/?-http://-/?-http://dx.doi.org/10.1787/888932315602http://dx.doi.org/10.1787/888932315602http://-/?-http://-/?-http://dx.doi.org/10.1787/888932315602http://dx.doi.org/10.1787/888932315602 -
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4. HEALTH CARE ACTIVITIES
HEALTH AT A GLANCE 2011: OECD INDICATORS OECD 2011 99
4.10. Cataract surgeries
4.10.1 Share of cataract surgeries carried out as day cases, 2000 and 2009 (or nearest year)
Source: OECD Health Data 2011.
1 2 http://dx.doi.org/10.1787/888932524925
4.10.2 Trends in cataract surgeries, inpatient and day cases, 2000-09 (or nearest year)
Source: OECD Health Data 2011.
1 2 http://dx.doi.org/10.1787/888932524944
100
80
60
40
20
0
2000 2009
82
.0
8
2.
8
8
3.1
92.
8
87.
3 90.
5
84.1
71.
2
9.
3
37.
6
61.
7
32.
0
52.
7
31.
5
41.
6
68.1
4.1
98.
2
99.
4
98.
8
98.
3
98.
0
97.
6
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96.
9
96.
0
95.
3
94.
5
93.
6
92.
5
91.
9
85.
4
85.
3
79.6
79.6
78.
9
78.
0
74.
2
65.
2
33.
8
24.
4
23.
9
13.
7
99.
6
99.
9
14.
3
% of total cataract surgeries
OEC
D17
Unite
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ds
Denm
ark
Unite
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dom
Sweden
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Spain
Austr
alia
Icelan
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Belgi
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Irelan
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CzechR
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France
Israel
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Hung
ary
Slovak
Republic
Polan
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60
50
40
30
20
10
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54.1
34.7
14.4
9.9 9.8 9.4 8.3 7.95.7 4.9 4.9 4.8 4.7 3.7 3.5
0.5
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-16.5
-4.9
-14.8
-9.4
-5.4
-12.6
-24.9
-16.7
13.4
Day cases Inpatient cases
Average annual growth rate in cataract surgeries per capita (%)
Portu
gal
Luxe
mbou
rg
France
Israel
Belgi
um
Irelan
d
Neth
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Denm
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Swed
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Switz
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Austr
alia
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aland
Canada
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Norw
ay
http://dx.doi.org/10.1787/888932524925http://dx.doi.org/10.1787/888932524944http://dx.doi.org/10.1787/888932524944http://dx.doi.org/10.1787/888932524925
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