IHE Publications

A systematic review of the accessibility, acceptability, safety, efficiency, clinical effectiveness, and cost-effectiveness of private cataract and orthopedic surgery clinics

Many publicly funded health systems use a mix of privately and publicly operated providers of care to deliver elective surgical services. The aim of this systematic review was to assess the role of privately operated but publicly funded provision of surgical services for adult patients who had cataract or orthopedic surgery within publicly funded health systems in high-income countries. The evidence identified on accessibility, acceptability, safety, efficiency, and clinical effectiveness does not show a clear advantage of one delivery model over another. Rather there are strengths and weaknesses for both models. Wait times were shorter for patients treated in private facilities. There was evidence that some private facilities cherry-pick or cream-skim by selecting less complex patients, which increases the postoperative length of stay and costs for public facilities, restricts access to private facilities for certain groups of patients, and increases inequality within the health system. Value for money of different models remains to be evaluated properly.

Publication Type: Journal Articles

Year of Publication: 2023

Topics: Cataracts, Health Policy, Orthopedic, Surgery

Authors: Ilke Akpinar, Erin Kirwin, Lisa Tjosvold, Dagmara Chojecki, Jeff Round

Journal Title: International Journal of Technology Assessment in Healthcare