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2015 ; 10
(9
): e0137913
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The Cost-Effectiveness Analysis of Teleglaucoma Screening Device
#MMPMID26382956
Thomas S
; Hodge W
; Malvankar-Mehta M
PLoS One
2015[]; 10
(9
): e0137913
PMID26382956
show ga
Glaucoma is the leading cause of irreversible vision loss and costs the American
economy $2.9 billion. Teleglaucoma remotely detects glaucoma improving access to
ophthalmic care in rural areas. It helps manage glaucoma more efficiently to
preserve vision and reduce healthcare costs. A cost-effectiveness analysis was
conducted using healthcare provider or third-party payer perspective within rural
Canada. The study population were patients at-risk of glaucoma which includes
those with diabetes and/or hypertension, family history of glaucoma, adults older
than 50 years, and concurrent ocular conditions in rural Alberta. Markov
modelling was used to model glaucoma health states. Effectiveness was measured in
Quality-Adjusted Life Years (QALYs) and costs were used in Canadian dollars.
Using TreeAge Pro 2009, incremental cost-effectiveness ratios (ICER) were
developed in dollars per QALYs. Deterministic and probabilistic sensitivity
analyses were performed to assess the factors affecting cost-effectiveness.
Teleglaucoma had a 20% increase in ophthalmologist-referral rate; it reduced
patient travel times by 61 hours and physician wait times by 30% in comparison to
in-person examination (standard of care). Teleglaucoma costs $872 per patient
screened which was 80% less than in-person examination. Teleglaucoma had a
greater incremental effectiveness providing an additional 0.12 QALY per patient
examination. It was more sensitive (86.5%) and less specific (78.6%) than
in-person examination. Teleglaucoma was more cost-effective than in-person
examination with an ICER of-$27,460/QALY. This indicated that teleglaucoma will
save $27, 460 for each additional QALY gained. Long term benefits showed
teleglaucoma prevents 24% cases of glaucoma blindness after 30 years.
Teleglaucoma demonstrated improved health outcomes, as well as, cost benefits. It
increases access to ophthalmic care and improves healthcare service efficiency,
specifically in rural areas. Teleglaucoma is more cost-effective than current
in-person examination and can improve the quality of life in glaucoma patients.
free
free
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