The objectives of this study were to compare the costs and effectiveness of cataract surgery methods [i.e., Manual Small Incision Cataract surgery (MSICS) and Phacoemulsification (PHACO)] at Phrapoklao Hospital, Thailand, using the hospital’s perspective. Labor, material, and capital costs in the year 2005 were converted to 2006 Thai Baht value by Consumer Price Index and the effectiveness was measured in visual acuity (VA), astigmatism and complications occurring at 1, 2, 7, 14, 28, and 90 days after surgery. Data were collected from medical charts and through patient interviews using data collection forms. The target population was cataract patients selected based on a convenience sampling method for cataract surgery. Descriptive statistics were performed using SPSS version 11.5. Results showed that the average total cost was 10,043.81 Baht/case for MSICS and 11,591.32 Baht/case for PHACO. After 90 days of surgery, the average VA of MSICS and PHACO groups were 0.83 (SD= +- 0.255, Range=0.10-1.00) and 0.74 (SD= +-0.268, Range=0.06-1.00). The average additional VA was 0.76 (SD= +- 0.255, Range=0.00-0.98) and 0.66 (SD= +- 0.266, Range=0.01-0.98) for MSICS and PHACO, respectively. There was no statistically significant difference in all VA values at 90 days after surgery between the two groups. For astigmatism, the average astigmatism at 90 days after surgery was 1.01 D (SD= +- 0.733, Range 0.00-3.50), and 0.99 D (SD= +- 0.731, Range=0.00-4.25) for MSICS and PHACO method, respectively. However, the average change in astigmatism was 0.15 D and 0.20 D for the MSICS and PHACO group, respectively. The intraoperative complication was vitreous loss (1.40%) in the PHACO group, and for postoperative complications, corneal edemas (5.60%) in the MSICS group. There was no statistically significant difference in the number of postoperative complications between two methods at 90 days after surgery. Results showed that the effectiveness (i.e., VA) of MSICS and PHACO methods was not significantly different, but PHACO method consumed higher costs. Therefore, MSICS might be a preferred cataract surgery method to PHACO method at Phrapoklao Hospital, based on the hospital’s perspective.

Pharmacy Administration Pharmacy Administration มหาวิทยาลัยมหิดล ปี 2550

effectiveness, cataract, incision, Manual, Phacoemulsification, Small, Cost, analysis