Comparative costs of cataract surgery in a public and a private hospital

A total of 119 patients undergoing cataract surgery in Wellington and Wellcare hospitals were studied for their demographic characteristics and the costs of their surgery. There were no significant age or sex differences between public and private sector patients and, although there were marital, ethnic and socioeconomic factors which were associated with a slightly longer stay in the public sector, these explain only a small proportion of the difference of 5.0 days in public as compared with 2.5 days stay in the private sector. The pattern of care adopted by the consultant and ward staff and medical profile affected the length of stay. The costs of the surgery were identical at $2560, including GST, in both public and private hospitals. Higher ward costs in public were offset by higher surgical costs in the private sector. A study of the marginal costs, on a day by day basis, indicated that a reduction in length of stay to 3.6 days, which has already occurred since the study, would lead to an 11% increase in throughout of cataract patients within a fixed budget. These costing data will be routinely provided by the RUS (resource utilisation system) now being implemented in New Zealand hospitals and will be an important tool for service management in making decisions about both quality of care and cost containment.