Cataract surgery costs, complications low at Aravind

Orlando-Due to the extraordinarily high volume and minimal surgeon time, the average cataract cost-including IOL choice-ranges from $41 to $125 at India’s Aravind Eye Hospital, said David W. Hutton, PhD.

“The surgeon is a small part of the process and only does what is absolutely required,” said Dr. Hutton, University of Michigan, Ann Arbor, MI.

Hutton explained that this means at any point in time, there are four nurses in the operating room, and two patients per room. As the surgeon operates on one patient, the second is being prepped for surgery. Aravind averages 65 patients/day, yet boasts only a 1.5% complication rate, and a 0.02% endophthalmitis rate.

“Complications are half of what they are in the United Kingdom,” he said.

Aravind operates under a “first-come, first-serve” basis, Dr. Hutton said, but “82% of patients spend less than 5 hours in the hospital.”

Total direct and indirect costs to Aravind for each cataract surgery procedure in 2013 were $29.02. Patients also paid for their choice of IOLs, with costs ranging from $12.80 for an aspheric Indian (Aurolab) manufactured lens, to $96.00 for an internationally produced aspheric lens.

Aurolab is Aravind’s manufacturing facility.

Labor costs were minimal, with surgeon costs averaging $2.25/patient and $4.81/patient for everyone else. Comparatively, in the United States, Medicare reimburses the same surgery at $1,766 for the ambulatory surgery center and $760 per surgeon, and average time per surgery is calculated at 21 minutes (at Aravind, surgeries take an average of 6 minutes).

“The process is replicable if there is a high volume of patients,” he said. “But you also need very specialized personnel.”

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