A Multi-National, Retrospective Study of Resource Utilization Associated with Glaucoma disease Progression in Europe

Abstract

Abstract: : Purpose: To conduct a multi-national retrospective chart review with the purposes of assessing resource utilization, progression, and costs associated with treating glaucoma in Europe. Methods: Participating centers were identified across European nations including Austria, France, Germany, Italy, and United Kingdom. The Bascom Palmer Glaucoma Staging System (GSS) was selected, as most adaptable because it allows for structured severity stage assignment, and modifications were performed in order to encompass disease severity ranging from patients with no/minimal glaucomatous damage to blind patients. Patient chart data was reviewed to assign patients to 6 stages of glaucoma progression. The GSS was applied to approximately 12 charts per center, selected according to the inclusion/exclusion criteria specified in the study protocol, to classify patients by disease severity. Clinical and demographic data including office visits, exams, procedures and anti-glaucoma medications were obtained from the charts. Financial data were obtained from public sources in each country. Results: The final GSS comprises six stages based principally on visual field parameters. We used the GSS to successfully classify over 180 identified charts of glaucoma patients from normal to end-stage disease and facilitate resource utilization abstraction by each individual stage. Reimbursement costs varied by country and by region within some countries. In general resource utilization and thus direct costs increased with increasing severity of glaucoma across Europe. Conclusions: An improved GSS to track progression was designed for Europe which allows staging of all patients from historical chart data. Data collected demonstrate a trend of increasing resource consumption with glaucoma progression in Europe. Overall total direct costs increased with worsening glaucoma severity across Europe.

Keywords: visual fields • clinical (human) or epidemiologic studies: hea • clinical (human) or epidemiologic studies: out