Corneal Physician Bulletin: Too Much Testing Leads to Patient Falls?

Routine Preoperative Medical Testing Overuse Linked With Delayed Cataract Surgery and Increase Patient Falls in Medicare Beneficiaries

The overuse of routine preoperative medical testing by high-testing doctors is associated with postponement of cataract surgery and increased falls in patients waiting to undergo the procedure, reported Ophthalmology.1

Specifically, more patients who were managed by high-testing doctors waited ≥30 days and ≥90 days to undergo cataract surgery (31.4% and 8.2% vs. 25.0% and 5.5%, respectively; P<0.0001 for both), and falls prior to surgery in these patients increased by 43% within 90 days after ocular biometry (1.0% vs. 0.7%; P<0.0001). Additionally, the adjusted odds ratio of patients managed by high-testing doctors falling within 90 days of undergoing biometry was 1.10 (95% confidence interval [CI], 1.03-1.19; P=0.008) vs. patients managed by low-testing doctors. Further, after compensating for surgery wait time, this odds ratio reduced to 1.07 (95% CI, 1.00-1.15; P=0.06).

The surgical delay linked with having a high-testing doctor was approximately 8 days (estimate, 7.97 days; 95% CI, 6.40 to 9.55 days; P<0.0001). Other factors linked with surgical postponement were patient race (non-White), Northeast region, ophthalmologist ≤40 years of age, and low surgical volume. 

The study was comprised of 248,345 beneficiaries, 16.4% of whom were managed by high-testing doctors.