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Emily Schehlein, Lily Im, Alan L Robin, Osamah Saeedi; Costs of Glaucoma Care to Patients. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2126.
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Office visits required for routine glaucoma care cost billions in direct costs, but the costs of these visits to the patient (patient cost) have not been assessed in the United States. Knowledge of patients’ costs of glaucoma monitoring is critical to better assess the cost-effectiveness of alternative models of glaucoma health care delivery.
We designed and distributed a cross-sectional survey to 300 patients with glaucoma in hospital-based and community-based glaucoma subspecialty clinics. The survey included demographic factors and all patient costs related to the visit including cost of transportation, time, child care, and lost wages. We graded patient visual fields by severity using Brusini’s GSS-2 staging model. We calculated the mean cost per visit and yearly costs per patient. We determined predictors of mean and yearly cost using univariate and multivariate analysis.
Of the 300 patients, 187 (62%) were female, 171 (57%) were African American, and 114 (38%) were Caucasian. The mean age was 65 +/- 14 years. The mean patient cost per visit was $38.02 +/- $73.15. The mean yearly cost of all visits was $176.09 +/- $327.23. The mean cost of the visit including leisure time lost was $44.09 +/- $72.67. The mean yearly cost of the visit including leisure time lost was $210.41 +/- $333.32. Patients with companions paid significantly more ($51.42 +/- $90.65 vs $26.60 +/- $51.58, P < .001) and retired patients paid significantly less ($21.64 +/- $25.67 vs $51.42 +/- $93.89, P = .038). Mean cost per visit did not vary with age (P = .340), gender (P = .409), race (P = .274), disease severity (P = .928), or education (P = .084). Median household income (P = .005) and presence of companion (P < .001) were significant predictors for increased yearly cost. Additionally, there was no significant difference in mean cost between patients attending either the community-based or hospital-based clinics (P = .308).
We found that specific patient groups have an increased cost burden for glaucoma care. We determined that patients with companions and those currently employed paid significantly more for each visit, while patients with a high median household income paid significantly more per year. Our study is the first to comprehensively assess these costs in the United States. These results show the need to potentially reevaluate the frequency of visits or perhaps utilize telemedicine to reduce the patient cost.
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