Simultaneous bilateral cataract surgery: Financial differences among nations and jurisdictions
Bibliographic record
Abstract
PURPOSE: To identify and measure financial pressures surrounding unilateral and simultaneous bilateral cataract surgery in Canada and other Western nations to understand financial factors that may affect simultaneous bilateral cataract surgery. SETTING: Eye Foundation of Canada, York Finch Eye Associates, Humber River Regional Hospital, University of Toronto, Toronto, Ontario, Canada. METHODS: Schedules of physician benefits from 4 Canadian provinces and public and private sectors in the United States were applied to a consistent template for unilateral and simultaneous bilateral cataract surgery. Well-known surgeons from the United Kingdom, Australia, Japan, and Israel provided additional information. The data were analyzed for similarities and differences to identify financial factors that may influence surgeons and anesthesiologists regarding simultaneous bilateral cataract surgery. RESULTS: Simultaneous bilateral cataract surgery yielded approximately 15% greater efficiency in the number of daily operations. Ophthalmologists' surgical fees were variably discounted for the second cataract surgery, up to 100% in some jurisdictions. Financial incentive issues were compounded by widely differing reimbursement schemes across regions. Anesthesiologists were generally reimbursed for simultaneous bilateral cataract surgery through additional time units of pay, not for additional surgical complexity. Simultaneous bilateral cataract surgery led to greater administrative, laboratory, and nursing efficiencies for institutions with minimal increases in overall complexity. CONCLUSIONS: Results show that discounting second-eye cataract surgery in simultaneous bilateral cataract surgery was a financial deterrent. Although increased efficiency was a slight incentive to ophthalmologists and surgical centers, anesthesiologists experienced significant financial disincentives.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".