Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia
Abstract
:1. Introduction
2. Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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N (%) | |||||
---|---|---|---|---|---|
Surgical Outcome | |||||
Total (N = 151) | Unsuccessful (N = 21) | Successful (N = 130) | p | ||
Sex | Males | 90 (59.6) | 11 (52.4) | 79 (60.8) | 0.467 |
Females | 61 (40.4) | 10 (47.6) | 51 (39.2) | ||
Age | <40 | 10 (6.6) | 1 (4.8) | 9 (6.9) | 0.784 |
40–49 | 12 (7.9) | 3 (14.3) | 9 (6.9) | ||
50–59 | 38 (25.2) | 4 [19] | 34 (26.2) | ||
60–69 | 49 (32.5) | 7 (33.3) | 42 (32.3) | ||
≥70 | 42 (27.8) | 6 (28.6) | 36 (27.7) | ||
Eye | Right | 80 (53.0) | 13 (61.9) | 67 (51.5) | 0.377 |
Left | 71 (47.0) | 8 (38.1) | 63 (48.5) | ||
Age (years) | Median (Q1–Q3; min-max) | 63 (54–70; 18–88) | 63 (58–70; 26–81) | 63 (54–71; 18–88) | 0.914 |
N (%) | |||||
---|---|---|---|---|---|
Surgical Outcome | |||||
Total (N = 151) | Unsuccessful (N = 21) | Successful (N = 130) | p | ||
Symptoms duration (days) 1 | <15 | 102 (71.8) | 9 (47.4) | 93 (75.6) | 0.011 |
≥15 | 40 (28.2) | 10 (52.6) | 30 (24.4) | ||
Myopia | Yes | 37 (24.5) | 6 (28.6) | 31 (23.9) | 0.640 |
No | 114 (75.5) | 15 (71.4) | 99 (76.1) | ||
Trauma | Yes | 9 (6.0) | 3 (14.3) | 6 (4.6) | 0.082 |
No | 142 (94.0) | 18 (85.7) | 124 (95.4) | ||
Macula status 1 | Attached | 63 (42.6) | 12 (60.0) | 51 (39.8) | 0.090 |
Detached | 85 (57.4) | 8 (40.0) | 77 (60.2) | ||
Retinal tear 1 | Found | 124 (83.8) | 13 (65.0) | 111 (86.7) | 0.014 |
Not found 2 | 24 (16.2) | 7 (35.0) | 17 (13.3) | ||
Retinal tear shape 1 | Horseshoe | 76 (51.4) | 7 (35.0) | 69 (53.9) | 0.126 |
Round | 23 (15.5) | 4 (20.0) | 19 (14.8) | ||
Horseshoe + round | 17 (11.5) | 1 (5.0) | 16 (12.5) | ||
Gigantic | 4 (2.7) | 1 (5.0) | 3 (2.3) | ||
Linear | 4 (2.7) | 0 | 4 (3.1) | ||
Not found 2 | 24 (16.2) | 7 (35.0) | 7 (35.0) | ||
Lens status | Phakic | 94 (62.2) | 10 (47.6) | 84 (64.6) | 0.136 |
Pseudophakic | 57 (37.8) | 11 (52.4) | 46 (35.4) | ||
PVD | Yes | 138 (91.4) | 21 (100.0) | 117 (90.0) | 0.130 |
No | 13 (8.6) | 0 (0.0) | 13 (10.0) | ||
PD | Yes | 58 (38.4) | 9 (42.9) | 49 (37.7) | 0.834 |
No | 93 (61.6) | 12 (57.1) | 81 (62.3) |
Surgical Outcome | |||||
---|---|---|---|---|---|
Total (N = 151) | Unsuccessful (N = 21) | Successful (N = 130) | p | ||
N (%) | |||||
Type of surgical procedure | Pneumoretinopexy | 32 (21.2) | 5 (23.8) | 27 (20.8) | 0.540 |
Scleral buckling | 13 (8.6) | 3 (14.3) | 10 (7.7) | ||
PPV | 106 (70.2) | 13 (61.9) | 93 (71.5) | ||
PHACO + PPV | Yes | 33 (31.1) | 2 (15.4) | 31 (33.3) | 0.322 |
No | 73 (68.9) | 11 (84.6) | 62 (66.7) |
Preoperative BVCA | p | |||
---|---|---|---|---|
≤0.1 (N = 108) | >0.1 and <0.5 (N = 17) | ≥0.5 (N = 26) | ||
N (%) | ||||
Final BCVA | ||||
≤0.1 | 55 (50.9) | 3 (17.6) | 2 (7.7) | <0.001 |
>0.1 and <0.5 | 32 (29.6) | 5 (29.4) | 2 (7.7) | |
≥0.5 | 21 (19.4) | 9 (52.9) | 22 (84.6) |
Final BCVA (Decimal) | ||||||
---|---|---|---|---|---|---|
Total | ≤0.1 | >0.1 and <0.5 | ≥0.5 | p | ||
N (%) | ||||||
Symptoms duration (days) 1 | ≤3 | 42 (29.6) | 14 (25.0) | 11(29.7) | 17 (34.7) | 0.043 |
4–7 | 37 (26.1) | 13 (23.2) | 8 (21.6) | 16 (32.7) | ||
8–14 | 23 (16.2) | 6 (10.7) | 8 (21.6) | 9 (18.4) | ||
15–30 | 20 (14.1) | 8 (14.3) | 7 (18.9) | 5 (10.2) | ||
>30 | 20 (14.1) | 15 (26.8) | 3 (8.1) | 2 (4.1) | ||
Macula status 1 | Attached | 63 (42.6) | 16 (27.1) | 14(36.8) | 33 (64.7) | <0.001 |
Detached | 85 (57.4) | 43 (72.9) | 24(63.2) | 18 (35.3) | ||
Type of surgical procedure | PR | 32 (21.2) | 6 (10.0) | 2 (5.1) | 24 (46.2) | <0.001 |
Scleral buckling | 13 (8.6) | 0 | 4 (10.3) | 9 (17.3) | ||
PPV | 106 (70.2) | 54 (90.0) | 33(84.6) | 19 (36.5) | ||
Lens status | Phakic | 94 (62.2) | 40 (66.7) | 17(43.6) | 37 (71) | 0.018 |
Pseudophakic | 57 (37.8) | 20 (33.3) | 22(56.4) | 15 (29) |
Surgical Procedure | DRG Cost (Day Surgery (€)) | Procedure Time (min) | Cost per min for Day Surgery (€/min) | Estimated DRG Cost (Day Surgery (€)) | Inpatient DRG Cost (All Retinal and Cataract Procedures (€)) | Cost per min for Inpatient Surgery (€/min) | Estimated DRG Cost (Inpatient Surgery (€)) |
---|---|---|---|---|---|---|---|
PR | N/A | 15 | N/A | 482.85 | 1321.63 | N/A | 396.45 |
SB | N/P | 85 | N/A | 2736.15 | 1321.63 | N/A | 2246.55 |
PPV | 1609.39 | 50 | 32.19 | * | 1321.63 | 26.43 | *** |
PHACO+PPV | 1960.58 | 62.5 | 35.38 | 2211.03 ** | 1321.63 | 29.30 | 1831.01 |
PHACO | 601.64 | 12.5 | 48.13 | * | 509.38 | 40.75 | * |
Surgical Procedure | Surgical Outcome | BCVA | Probability | Utility Value * | Expected QALY | |
---|---|---|---|---|---|---|
PR | Unsuccessful | ≤0.1 | 0.096 | 0.5 | 0.05 | 0.11 |
≥0.5 | 0.064 | 0.9 | 0.06 | |||
Successful | ≤0.1 | 0.084 | 0.5 | 0.04 | 0.70 | |
>0.1 and <0.5 | 0.084 | 0.7 | 0.06 | |||
≥0.5 | 0.672 | 0.9 | 0.60 | |||
0.81 | ||||||
SB | Unsuccessful | >0.1 and <0.5 | 0.066 | 0.5 | 0.03 | 0.15 |
≥0.5 | 0.134 | 0.9 | 0.12 | |||
Successful | >0.1 and <0.5 | 0.24 | 0.7 | 0.17 | 0.67 | |
≥0.5 | 0.56 | 0.9 | 0.50 | |||
0.82 | ||||||
PPV | Unsuccessful | ≤0.1 | 0.09 | 0.5 | 0.05 | 0.07 |
>0.1 and <0.5 | 0.018 | 0.7 | 0.01 | |||
≥0.5 | 0.0096 | 0.9 | 0.01 | |||
Successful | ≤0.1 | 0.44 | 0.5 | 0.22 | 0.56 | |
>0.1 and <0.5 | 0.264 | 0.7 | 0.18 | |||
≥0.5 | 0.176 | 0.9 | 0.16 | |||
0.63 |
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Borjan, I.; Pleština-Borjan, I.; Hertzberg, S.N.W.; Siničić, A.; Znaor, L.; Petrovski, B.É.; Petrovski, G. Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia. Healthcare 2024, 12, 648. https://doi.org/10.3390/healthcare12060648
Borjan I, Pleština-Borjan I, Hertzberg SNW, Siničić A, Znaor L, Petrovski BÉ, Petrovski G. Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia. Healthcare. 2024; 12(6):648. https://doi.org/10.3390/healthcare12060648
Chicago/Turabian StyleBorjan, Ivan, Ivna Pleština-Borjan, Silvia N. W. Hertzberg, Alen Siničić, Ljubo Znaor, Beáta Éva Petrovski, and Goran Petrovski. 2024. "Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia" Healthcare 12, no. 6: 648. https://doi.org/10.3390/healthcare12060648
APA StyleBorjan, I., Pleština-Borjan, I., Hertzberg, S. N. W., Siničić, A., Znaor, L., Petrovski, B. É., & Petrovski, G. (2024). Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia. Healthcare, 12(6), 648. https://doi.org/10.3390/healthcare12060648