Posters

Analysis of patient-reported outcome measure (PROM) with cataract surgery in a rural German area

Poster Details

First Author: H. Höh GERMANY

Co Author(s):    M. Seifried                    

Abstract Details

Purpose:

The data collection took place between 2005 and 2008 based on a contract concluded in April 2005 due to § 140 a SGB V between the social insurance company AOK MV and the outpatient cataract surgeons in practice and hospitals in Mecklenburg-Vorpommern, Germany. Goal of the study is to measure the quality of cataract surgery in both sectors of the German health care system with identical criteria (questionnaire) in a rural area like Mecklenburg-Vorpommern. Of the initially data sets of 3058 eyes, we could use the data sets of 2952 eyes for evaluation after plausibility checks, exclusions and modifications.

Setting:

Department of Ophthalmology, Dietrich-Bonhoeffer-Klinikum, Neubrandenburg, Germany

Methods:

We consider pre- and postoperative visual acuity and refraction. The patient-reported outcome measure (PROM) was analysed based on four questions: 1. Are you content with the outcome of your cataract surgery (overall satisfaction with surgery)? 2. Is your vision helpful for coping with the everyday life now (everyday life)? 3. Are you more confident in the streets now (traffic safety)? 4. Is it easier for you to read after the operation (reading abilities)? Question Number 1 could be answered with „yes“, „no“ or „limited“, the other questions with „yes“, „no“ or „not applicable“. We looked for influencing factors.

Results:

Mean visusal acuity (VA) increased from 0,36±0,19 (LogMar 0,54±0,33) to 0,75±0,25 (LogMar 0,17±0,24). 78,86 % (respectively 49,86 %) of the eyes reached their aimed refraction ±1,0 D (respectively ±0,5 D). The overall satisfaction with surgery correlates (Spearman, p=0,01) with postoperative VA (r=0,404) and with presence of comorbidities (r=0,168) and complications during operation (r=-0,104). The mean negative PROM (PROM-) in the four sections was 9,5 %. 1,7 % of our patients with PROM- had no comorbidity, no complication and no poor outcome (clinical outcome measure COM+).

Conclusions:

In non-selected patients we reached PROM+ which compare well with international PROMs. Main factors for negative PROM were comorbidity and unrealisitic expectations of patients. Low overall satisfaction could be only explained by objective reasons up to a certain ratio (comorbidities, complications and poor outcome, means no increased visual acuity ≥ 0,1). We assume, that this group have a low general life satisfaction. Nevertheless we didn't measure it with a standardised questionnaire - so our assumption stays speculative. The quality of surgery and the quality of aftercare is a crucial factor for positive PROM after cataract surgery.

Financial Disclosure:

NONE