Cost analysis of a school-based vision program in Baltimore, MD

Abstract

Purpose : School-based vision programs bring care directly to students, which is particularly important in high-poverty neighborhoods where students are less likely to access eyecare in traditional settings. Little is known about the costs of school-based eyecare programs in the United States, however some reports demonstrate cost-effectiveness in India. We conducted a one-year cost analysis of a school-based vision program in Baltimore, MD.

Methods : Total operating costs for one year of the school-based eyecare program, Vision for Baltimore, were calculated based on costs incurred by the Baltimore City Health Department (BCHD), Vision To Learn (VTL), and Johns Hopkins University (JHU), the three entities responsible for administering the program. These included the cost of personnel and equipment associated with screening and eye exams, the cost of eyeglasses, and support provided to schools to promote program participation and encourage wear of eyeglasses. We also calculated the average cost per student screened.

Results : During one year of Vision for Baltimore, 17,614 students received eyecare services (see Image 1) at a total cost of $816,291. This includes costs of $305,200 for vision screenings (17,614 students), $260,659 for mobile vision clinic exams (2,920 students), and $250,432 for school support. The program cost per student screened was $46. If students were provided not one but two pairs of eyeglasses, the cost would increase by $2 per student screened. By comparison, the average cost per pupil of education for a student attending a Maryland public school in 2016 was $14,917.

Conclusions : School-based vision screening and eyeglass provision for students in low income schools cost less than $50 per student screened, 0.3% of the annual cost to educate a child. School-based care removes most barriers and allows for closer monitoring of eyeglass use by students. Additional research to determine the cost and benefit of school-based eyecare is warranted.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Students served during one year of Vision for Baltimore.