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Laura Pizzi, Michael Waisbourd, Lisa A Hark, Katherine M. Prioli, L. Jay Katz; Costs of a Community-Based Glaucoma Detection Program: Analysis of the Philadelphia Glaucoma Detection and Treatment Project. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1619.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma is the foremost cause of irreversible blindness in the world, and more than 50% of glaucoma cases remain undiagnosed. The prevalence of glaucoma and its costs of treatment are rapidly increasing. Previous studies reported the cost-effectiveness of treating glaucoma, but few examine the costs of community-based examination programs. The objective of this project is to report the costs of a six-step, community-based glaucoma detection program delivered to at-risk individuals through senior centers, senior housing, and churches in Philadelphia.
A cost analysis was performed using a health care system perspective in $US2013 and included costs of the six-step examination and educational workshops. Measures were total program costs, cost per case of glaucoma detected, and cost per case of any ocular disease detected (including glaucoma). Diagnoses were reported at the individual level and therefore represent a diagnosis made in one or both eyes. Staff time costs were captured during site visits to 15 of the 43 sites and included the time to deliver the examinations and workshops, supervision, training, and travel. Staff time was converted to costs by applying wage and fringe benefit costs obtained from the U.S. Bureau of Labor and Statistics (BLS). Non-staff costs (equipment and mileage reimbursements) were collected using study logs.
1,649 participants received a glaucoma examination. The mean total examination time was 56 (SD 4) minutes per participant, including all six steps. The mean total cost per participant to deliver the examination was $139. The cost per case of glaucoma newly identified (open angle or angle closure) was $420 and cost per case for any ocular disease identified was $273.
Glaucoma examinations delivered through the Philadelphia Glaucoma Detection and Treatment Project provided significant health benefit to hard-to-reach communities in terms of ocular diseases identified. On a per-person basis, the examinations were fairly low cost, though opportunities exist to improve efficiency. Findings serve as an important benchmark for planning future community-based glaucoma examination programs.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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