Cost-effectiveness of monitoring glaucoma patients in shared care: an economic evaluation alongside a randomized controlled trial

• मुख्य लेखकों: Klazinga Niek S (लेखक), Plochg Thomas (लेखक), Lemij Hans G (लेखक), van Sprundel Esther (लेखक), Holtzer-Goor Kim M (लेखक), Koopmanschap Marc A (लेखक)
• स्वरूप: पुस्तक
• प्रकाशित: BMC, 2010-11-01T00:00:00Z.
• विषय: article
• ऑनलाइन पहुंच: Connect to this object online.
• Notes: 10.1186/1472-6963-10-312; 1472-6963
• Keywords: Public aspects of medicine; RA1-1270
• Source: BMC Health Services Research, Vol 10, Iss 1, p 312 (2010)

<p>Abstract</p> <p>Background</p> <p>Population aging increases the number of glaucoma patients which leads to higher workloads of glaucoma specialists. If stable glaucoma patients were monitored by optometrists and ophthalmic technicians in a glaucoma follow-up unit (GFU) rather than by glaucoma specialists, the specialists' workload and waiting lists might be reduced.</p> <p>We compared costs and quality of care at the GFU with those of usual care by glaucoma specialists in the Rotterdam Eye Hospital (REH) in a 30-month randomized clinical trial. Because quality of care turned out to be similar, we focus here on the costs.</p> <p>Methods</p> <p>Stable glaucoma patients were randomized between the GFU and the glaucoma specialist group. Costs per patient year were calculated from four perspectives: those of patients, the Rotterdam Eye Hospital (REH), Dutch healthcare system, and society. The outcome measures were: compliance to the protocol; patient satisfaction; stability according to the practitioner; mean difference in IOP; results of the examinations; and number of treatment changes.</p> <p>Results</p> <p>Baseline characteristics (such as age, intraocular pressure and target pressure) were comparable between the GFU group (n = 410) and the glaucoma specialist group (n = 405).</p> <p>Despite a higher number of visits per year, mean hospital costs per patient year were lower in the GFU group (€139 vs. €161). Patients' time and travel costs were similar. Healthcare costs were significantly lower for the GFU group (€230 vs. €251), as were societal costs (€310 vs. €339) (p < 0.01). Bootstrap-, sensitivity- and scenario-analyses showed that the costs were robust when varying hospital policy and the duration of visits and tests.</p> <p>Conclusion</p> <p>We conclude that this GFU is cost-effective and deserves to be considered for implementation in other hospitals.</p>