An economic analysis of postoperative cataract consultation using remote self-assessment

To evaluate the potential savings realized by replacing the 4-6 weeks consultation following cataract surgery with remote self-assessment. In addition, we evaluated the costs associated with adverse events (AEs) from a societal perspective and evaluated the current cost of AEs based on published literature and publicly available datasets. We determined the cost reduction when replacing the in-person 4-6-week postoperative consultation visit with remote self-assessment using our previous clinical trial, publicly available healthcare resource databases, and threshold analysis to determine the effect on cost if the incidence of AEs is affected by conducting an online self-assessment. We collected AE probabilities and costs of AEs based on published literature and databases. and performed a threshold analysis to demonstrate the financial impact if the incidence of AEs is altered versus the savings due to replacing the 4-6 weeks in-person consultation with remote self-assessment. Remote self-assessments resulted in an average savings between -€83 and -€92 per patient. Physical consultations were less costly only if >80% of remote self-assessments warranted an in-person follow-up. The mean cost of AEs per patient was estimated to be €16.35 and were attributed primarily to rare but severe complications, including endophthalmitis and retinal detachment. Having patients participate in a remote self-assessment following cataract surgery is expected to reduce costs under a wide range of assumptions. Due to the lack of published data regarding the utility loss due to AEs, quality of life was not included in our analysis; nevertheless, these cost savings should be balanced by the clinical impact of potentially missing relatively rare AEs. These findings contribute to the ongoing discussion regarding appropriate care following cataract surgery.