7/29/2019 pembedahan katarak

1/4

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

7/29/2019 pembedahan katarak

2/4

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.

7/29/2019 pembedahan katarak

3/4

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

7/29/2019 pembedahan katarak

4/4

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

97.1

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

dStat

es

Cana

da

Eston

ia

Finlan

d

Neth

erlan

ds

Denm

ark

Unite

dKing

dom

Sweden

Norw

ay

NewZe

aland

Spain

Austr

alia

Icelan

d

Belgi

um

Portu

gal

Italy

Irelan

d

Switz

erlan

d

CzechR

epublic

France

Israel

Mexic

o

Slove

nia

Luxe

mbou

rg

Hung

ary

Slovak

Republic

Polan

d

60

50

40

30

20

10

0

-10

-20

-30

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

-8.6

1.0

-8.8-5.9

-12.7 -13.5

-20.6

-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

erlan

ds

Denm

ark

Swed

en

Switz

erlan

d

Austr

alia

NewZe

aland

Canada

Finlan

d

Mexic

o

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