Cost analysis shows greater losses for pediatric versus adult retinal detachment repairs
Key Takeaways
- Pediatric standard retinal detachment repair with pars plana vitrectomy had significantly higher total and day-of-surgery costs than comparable adult procedures.
- Medicare reimbursement failed to cover full procedural costs for several retinal detachment surgeries, with pediatric cases generally resulting in larger net financial losses than adult surgeries.
Pediatric patients undergoing standard retinal detachment (RD) repair with pars plana vitrectomy (PPV) incurred substantially higher costs and larger financial losses under Medicare reimbursement compared with adults, according to a recent cost analysis.
Investigators analyzed 103 pediatric cases and 549 adult cases using time-driven activity-based costing methodology and compared costs for scleral buckle, standard RD repair, and complex RD repair procedures.
For scleral buckle surgery, total costs did not differ significantly between pediatric and adult patients, at $8,884.23 and $7,878.26, respectively.
However, pediatric standard RD repair procedures were significantly more expensive than adult cases. Total material costs were $1,366.71 in pediatric patients compared with $1,023.66 in adults, while overall procedure costs reached $8,163.56 versus $5,076.18, respectively. Day-of-surgery time costs were also higher in pediatric patients, at $6,796.87 compared with $4,087.74 for adults.
For complex RD repair, total costs were similar between pediatric and adult patients, at $10,261.20 and $9,528, respectively.
Medicare reimbursement rates resulted in negative net margins for several procedures. Net margin losses for pediatric versus adult patients were -$3,296.52 versus -$2,323.55 for scleral buckle surgery, -$2,568.45 versus +$430.93 for standard PPV repair, and -$4,467.92 versus -$3,745.72 for complex PPV repair.
Reference
Pan WW, Fleifil S, Portney DS, et al. Comparative Cost Analysis of Pediatric and Adult Retinal Detachment Repairs Using Time-Driven Activity-Based Costing. J Vitreoretin Dis. 2026;24741264261445240. doi: 10.1177/24741264261445240. Epub ahead of print. PMID: 42147785; PMCID: PMC13179302.
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