April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Cost analysis of telemedicine diabetic retinopathy screening in a county hospital population
Author Affiliations & Notes
  • Anh-Danh T Phan
    Ophthalmology, Indiana University / Glick Eye Institute, Indianapolis, IN
  • Allison Pernic
    Ophthalmology, Indiana University / Glick Eye Institute, Indianapolis, IN
  • Eric D Doerr
    Ophthalmology, Indiana University / Glick Eye Institute, Indianapolis, IN
  • Jacob J Koczman
    Ophthalmology, Indiana University / Glick Eye Institute, Indianapolis, IN
  • Chi-Wah Rudy Yung
    Ophthalmology, Indiana University / Glick Eye Institute, Indianapolis, IN
  • Mark M Kaehr
    Ophthalmology, Indiana University / Glick Eye Institute, Indianapolis, IN
  • Footnotes
    Commercial Relationships Anh-Danh Phan, None; Allison Pernic, None; Eric Doerr, None; Jacob Koczman, None; Chi-Wah Yung, None; Mark Kaehr, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5332. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Anh-Danh T Phan, Allison Pernic, Eric D Doerr, Jacob J Koczman, Chi-Wah Rudy Yung, Mark M Kaehr; Cost analysis of telemedicine diabetic retinopathy screening in a county hospital population. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5332.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

To determine, from the health insurer’s perspective, the cost of screening patients with diabetes mellitus through telemedicine within a county hospital setting and to calculate the cost-effectiveness of this intervention as compared with that of other medical screening interventions.

 
Methods
 

IRB-approved case series study, incorporating actual health insurance demographics. Patients were noncompliant with recommended yearly diabetic eye examination. Camera retinal imaging in the primary care clinic was obtained in place of traditional eye clinic examination. Patients having diabetic retinopathy (DR) or unreadable image(s) were further referred for eye clinic examination. Main outcome measures were: percentage of DR and unreadable images, health insurance- and physician work Relative Value Units (RVU)-rated cost of screening.

 
Results
 

Patient encounters totaled 1,793 at four primary care clinics between June 2009 and February 2013. DR was found in 15% of patient encounters. Medi-care- and Medi-caid-covered cost of screening was 16% less expensive when performed instead in the primary care setting. County health insurance accounted for the majority (43%) of patient encounters and was 32% less expensive. Physician work RVU analysis revealed nearly 700 eye clinic visits were avoided. Image(s) were unreadable in 20% of patient encounters.

 
Conclusions
 

Our analysis indicates that telemedicine screening aimed at improving eye care for diabetic persons in the county hospital setting with its unique payer demographics results in substantial county, state, and federal budgetary savings. Telemedicine screening for DR is more cost-effective than many routinely provided health interventions. Because diabetic eye disease is the leading cause of blindness among adult Americans, these results support widespread use of telemedicine as part of the medical care of diabetic persons in the county hospital setting. Additional savings can come by addressing image unreadability.

 
Keywords: 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower • 499 diabetic retinopathy  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×