Abstract
Purpose :
Across Europe inequity exists in provision of childhood screening. We gather data on screening programs, to use it in a disease-health model to predict and compare benefits and costs of screening programs, taking regional diversity and organisational and resource requirements into account. This cost-effectiveness model will assist healthcare providers in their decisions about introduction, modification or disinvestment of screening programs in the future.We report on collection of data on vision screening programs.
Methods :
A questionnaire (www.euscreen.org) with domains on demography, circumstances for screening, existing screening programs and health systems, uptake, screening tests, diagnostics, treatment options, envisaged health benefits, societal costs and adverse effects was filled out for each country by 3 Country Representatives (CRs) for vision, hearing and general pediatric screening, together comprising the Foundation EUS€REEN. For each country, reports were made on population and healthcare system, vision screening commissioning and guidance, age at vision screening, automated vision screening, provision for visually impaired, prevalence, diagnosis, screening coverage, treatment success, screening evaluation and cost of screening and of treatment for amblyopia, strabismus and cataract.
Results :
We had difficulty finding competent CRs willing to fill out the detailed questionnaire. Seven countries outside Europe contributed data. There was a high proportion of missing responses and uncertainty, in particular on disease prevalence, treatment costs and personnel costs. There is wide variation in vision screening programs, their availability, their organisation, screening tests and the methods by which data are collected and analysed. There was little communication about screening programs across borders.
Conclusions :
It proved difficult to gather robust evidence and data on country-specific contexts to support the efficacy of existing vision screening programs. Large regional differences exist (Germany, Austria, Italy, France, Spain, Belgium and UK). Even in countries with highly developed screening programs, good quality monitoring is lacking. In some countries, culturally different approaches to healthcare influence what children are eligible for screening and health-care reforms are needed to reach equity .
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.