Variation between surgeons in reoperation rates following vertical strabismus surgery: Associations with patient and surgeon characteristics and adjustable sutures

Christopher T Leffler, Alicia Woock, Meagan Shinbashi and Melissa Suggs

PLOS ONE, 2024, vol. 19, issue 11, 1-8

Abstract: Purpose: To quantify inter-surgeon variation in vertical strabismus surgery reoperation rates, and to explore associations of reoperation rate with practice type and volume, surgical techniques, and patient characteristics. Methods: Fee-for-service payments to providers in a national database for Medicare beneficiaries having vertical strabismus surgery between 2012 and 2020 were retrospectively analyzed to identify reoperations in the same calendar year. Predictors of the rate of reoperation for each surgeon were determined by multivariable linear regression. Results: Among 73 surgeons, the reoperation rate for 1-vertical muscle surgery varied from 0.0% to 40.7%. Due to the presence of high-volume surgeons with high reoperation rates, just 11% of surgeons contributed over half of the reoperation events for 1-vertical muscle surgery. Use of adjustable sutures, surgeon gender, and surgical volume were not independently associated with surgeon reoperation rate. Associations of reoperation with patient characteristics, such as age and poverty, were explored. Patient poverty was independently associated with a lower surgeon reoperation rate (p = 0.03). Still, the multivariable model could explain only 14.2% of the variation in surgeon reoperation rate for 1-vertical muscle. Conclusions: Patient-level analyses which ignore inter-surgeon variation will be dominated by the practices of a small number of high-volume, high-reoperation surgeons. There are order-of-magnitude variations in reoperation rates among strabismus surgeons, the cause of which remains largely unexplained.

Date: 2024
References: Add references at CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0310371 (text/html)
https://journals.plos.org/plosone/article/file?id= ... 10371&type=printable (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0310371

DOI: 10.1371/journal.pone.0310371

Access Statistics for this article

More articles in PLOS ONE from Public Library of Science
Bibliographic data for series maintained by plosone ().