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Measuring the Costs of Strabismus Surgery: A Time-Driven Activity-Based Costing Analysis
David S Portney1, David F Skanchy2, Jeremy N Shapiro3
1From the Kellogg Eye Center (D.S.P., A.D.V., C.G., P.E.W.), Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA; Grosinger, Spigelman, and Grey Eye Surgeons (D.S.P.), Bloomfield Hills, Michigan, USA.
The average cost of strabismus surgery is $4420, with specific factors like muscle number and reoperations significantly impacting the total expenses. Understanding these cost drivers is crucial for ensuring patient access to care.
Area of Science:
- Ophthalmology
- Health Economics
Background:
- Strabismus surgery costs and their drivers are not fully understood.
- Accurate cost analysis is needed to compare with reimbursement rates.
Purpose of the Study:
- To determine the costs and cost drivers of strabismus surgery.
- To examine factors influencing final surgery costs relative to reimbursement.
Main Methods:
- Economic analysis using time-driven activity-based costing (TDABC).
- Inclusion of adult and pediatric strabismus surgeries from 2022.
- Multivariate regression to assess the impact of surgical factors on time and cost.
Main Results:
- Average day-of-surgery cost was $4420 for 690 strabismus surgeries.
- Pediatric cases had shorter surgery times but similar costs to adults.
- Factors increasing costs included additional muscles, adjustable sutures, and reoperations.
Conclusions:
- TDABC analysis provides cost estimates based on surgical factors.
- Medicare reimbursement often does not cover the incremental costs of strabismus surgery.
- Understanding surgical economics is vital for maintaining access to care.
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