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Eileen Mayro, Douglas Wisner, Robert Bailey, Anish Koka, Adedoyin Okulate, Benjamin Leiby, Nooreen S Dabbish, Laura Pizzi, Ann P Murchison, Samantha Parker, Lisa Hark; The Effect of Mandatory On-Site Pre-Admission Testing on Resident-Performed Cataract Surgery Cancellation Rates. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6232.
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To evaluate the effect of mandatory on-site pre-admission testing in decreasing resident-performed cataract surgery cancellation rates.
Patients scheduled for cataract surgery in the resident clinic between January 5, 2015 and October 31, 2015 were randomized by week into two groups: usual care or intervention. Nursing home, dialysis, and incarcerated patients, and patients younger than age 18 were excluded. Patients randomized to the usual care group were provided with pre-admission testing (PAT) requirements at the time of cataract surgery scheduling and instructed to complete PAT at their own primary care physician. Patients randomized to the intervention group were required to complete same-day, on-site PAT at an affiliated cardiology practice and escorted by a research assistant. Patients in both groups received a reminder call by the ophthalmology resident or operating room staff 1-2 days prior to surgery. Statistical analysis consisted of univariate GEE model regression to account for clustering by week.
A total of 413 patients were enrolled in the study with 185 patients randomized to the intervention group and 228 patients randomized to the usual care group. Mean ages in the intervention and usual care groups were 66.1 ± 12.2 years and 64.6 ± 12.4 years, respectively. Patients were predominately female in both groups representing 54% of the intervention group and 58% of the usual care group. In the total sample (n=413), 229 patients (55%) were African American, 120 (29%) were Caucasian, 19 (5%) were Asian, and 19 (5%) were Hispanic/Latino. Pre-admission testing was completed in 95% of the intervention group compared to 92% of the usual care group (p=0.22). The cataract surgery cancellation rate in the intervention group was 12% compared to 15% in the usual care group (p=0.34).
No statistically significant difference was observed in resident-performed cataract surgery cancellation rates between the mandatory same-day, on-site PAT group and the usual care group. Pre-admission testing was completed by the majority of patients and low cancellations rates, 15% and 12%, were observed in both groups.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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