Premium intraocular lens adoption: Insights from a national health insurance analysis

Background: This study explores the utilization patterns of premium and nonpremium intraocular lenses (IOLs) under Taiwan's National Health Insurance, given the potential out-of-pocket expenses incurred by cataract surgery patients. Methods: A cross-sectional, population-based analysis was perf...

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Main Authors: Chi-Ying Huang, Christy Pu, Chiun-Ho Hou
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Journal of the Formosan Medical Association
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0929664624003474
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author Chi-Ying Huang
Christy Pu
Chiun-Ho Hou
author_facet Chi-Ying Huang
Christy Pu
Chiun-Ho Hou
author_sort Chi-Ying Huang
collection DOAJ
description Background: This study explores the utilization patterns of premium and nonpremium intraocular lenses (IOLs) under Taiwan's National Health Insurance, given the potential out-of-pocket expenses incurred by cataract surgery patients. Methods: A cross-sectional, population-based analysis was performed on patients who underwent IOL implantation between 2016 and 2020. IOLs were categorized into nonpremium and premium, with the latter further divided based on function. Logistic and multinomial logistic regression analyses were employed to identify factors influencing IOL implantation, with data stratified by medical institute type, ownership, and patient demographics. Results: In total, 1,194,805 IOLs were implanted during the study period. The rate of premium IOL implantation was lower compared to non-premium IOL implantation. However, the adoption rate of premium IOLs increased more rapidly than that of non-premium IOLs. Specifically, the adoption rate for premium IOLs was 35.2% in 2016, rising to 42.6% in 2020. Patients receiving treatment in clinics were considerably more likely to use nonpremium IOLs than were those receiving treatment in medical centers (12.7% higher probability for clinics; P < 0.001). The implantation of higher-end premium IOLs was more prevalent in clinics than in other medical institutes. The prevalence of premium IOL implantation was higher in private hospitals than in public hospitals (odds ratio: 1.403; P < 0.001). Premium IOLs were more commonly implanted in younger patients with higher income levels and without relative contraindications. Conclusion: IOL selection is associated with both personal and institutional characteristics. These factors should be considered in public policy development aimed at regulating the IOL market within a universal health insurance framework.
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spelling doaj-art-4fe76d400e6645db96a83db76cd4bb1e2025-08-20T03:56:41ZengElsevierJournal of the Formosan Medical Association0929-66462025-08-01124870671110.1016/j.jfma.2024.07.027Premium intraocular lens adoption: Insights from a national health insurance analysisChi-Ying Huang0Christy Pu1Chiun-Ho Hou2Institute of Hospital and Health Care Administration, National Yang-Ming Chiao Tung University, Taipei, TaiwanInstitute of Public Health, National Yang-Ming Chiao Tung University, Taipei, TaiwanDepartment of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. Department of Ophthalmology National Taiwan University Hospital 12F, Clinical Research Tower, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City, 100225, TaiwanBackground: This study explores the utilization patterns of premium and nonpremium intraocular lenses (IOLs) under Taiwan's National Health Insurance, given the potential out-of-pocket expenses incurred by cataract surgery patients. Methods: A cross-sectional, population-based analysis was performed on patients who underwent IOL implantation between 2016 and 2020. IOLs were categorized into nonpremium and premium, with the latter further divided based on function. Logistic and multinomial logistic regression analyses were employed to identify factors influencing IOL implantation, with data stratified by medical institute type, ownership, and patient demographics. Results: In total, 1,194,805 IOLs were implanted during the study period. The rate of premium IOL implantation was lower compared to non-premium IOL implantation. However, the adoption rate of premium IOLs increased more rapidly than that of non-premium IOLs. Specifically, the adoption rate for premium IOLs was 35.2% in 2016, rising to 42.6% in 2020. Patients receiving treatment in clinics were considerably more likely to use nonpremium IOLs than were those receiving treatment in medical centers (12.7% higher probability for clinics; P < 0.001). The implantation of higher-end premium IOLs was more prevalent in clinics than in other medical institutes. The prevalence of premium IOL implantation was higher in private hospitals than in public hospitals (odds ratio: 1.403; P < 0.001). Premium IOLs were more commonly implanted in younger patients with higher income levels and without relative contraindications. Conclusion: IOL selection is associated with both personal and institutional characteristics. These factors should be considered in public policy development aimed at regulating the IOL market within a universal health insurance framework.http://www.sciencedirect.com/science/article/pii/S0929664624003474Intraocular lensOut-of-pocket expenseToric lensMultifocal lensHealth insurance
spellingShingle Chi-Ying Huang
Christy Pu
Chiun-Ho Hou
Premium intraocular lens adoption: Insights from a national health insurance analysis
Journal of the Formosan Medical Association
Intraocular lens
Out-of-pocket expense
Toric lens
Multifocal lens
Health insurance
title Premium intraocular lens adoption: Insights from a national health insurance analysis
title_full Premium intraocular lens adoption: Insights from a national health insurance analysis
title_fullStr Premium intraocular lens adoption: Insights from a national health insurance analysis
title_full_unstemmed Premium intraocular lens adoption: Insights from a national health insurance analysis
title_short Premium intraocular lens adoption: Insights from a national health insurance analysis
title_sort premium intraocular lens adoption insights from a national health insurance analysis
topic Intraocular lens
Out-of-pocket expense
Toric lens
Multifocal lens
Health insurance
url http://www.sciencedirect.com/science/article/pii/S0929664624003474
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AT christypu premiumintraocularlensadoptioninsightsfromanationalhealthinsuranceanalysis
AT chiunhohou premiumintraocularlensadoptioninsightsfromanationalhealthinsuranceanalysis