Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/30659
Title: Implementing teleophthalmology services to improve cost-effectiveness of the national eye care system
Authors: Jørgensen, EP
Muttuvelu, DV
Peto, T
Natarajan, S
Davies, J
Keane, PA
Ehlers, LH
Keywords: health care economics;health services
Issue Date: 1-Oct-2024
Publisher: Springer Nature on behalf of The Royal College of Ophthalmologists
Citation: Jørgensen, E.P. et al. (2024) 'Implementing teleophthalmology services to improve cost-effectiveness of the national eye care system', Eye, 38 (14), pp. 2788 - 2795. doi: 10.1038/s41433-024-03156-4.
Abstract: Background and purpose: Optometrist-assisted and teleophthalmology-enabled referral pathway (OTRP) for community optometry referrals has the potential to improve the capacity and efficiency of eye care delivery systems through risk stratification and limiting the number of improved referrals. This study investigates the expected future costs and benefits of implementing OTRP under various possible organizational set-ups relevant to a Danish context. Methods: A decision-analytic model (decision tree) with a one-year time horizon was constructed to portray alternative future patient referral pathways for people examined in optometry stores for suspected ocular posterior segment eye disease. The main outcomes were total healthcare costs per patient, average waiting time from eye examination in store until the start of treatment or end of referral pathway, and quality-adjusted life-years (QALY) gained. The economic evaluation compares the general ophthalmologist referral pathway (GO-RP) with a potential reimbursement model for the optometrist-assisted teleophthalmology referral pathways (R-OTRP) and a procurement model for the optometrist-assisted teleophthalmology referral pathways (P-OTRP). Results: The cost per individual with suspected ocular posterior segment eye disease was estimated to be £116 for GO-RP and £75 and £94 for P-OTRP and R-OTRP respectively. The average waiting time for diagnosis or end of referral pathway was 25 weeks for GO-RP and 5.8 and 5.7 for P-OTPR and R-OTPR respectively. QALY gain was 0.15 for P-OTRP/R-OTRP compared to 0.06 for GO-RP. Conclusion: OTRP is effective in reducing unnecessary referrals and waiting times, increasing patients’ HRQoL, and decreasing the costs of diagnosing individuals with suspected ocular posterior segment eye disease.
Description: Data availability: All data generated or analyzed during this study are included in this published article. The TreeAge model is available from the corresponding author on reasonable request.
Summary: What was known before: Teleophthalmology represents an effective means for triaging patients; however, the cost-effectiveness of such services remains unexplored in the scientific literature. What this study adds: This research represents the first health economic evaluation of a nationwide teleophthalmology service, aiming to quantify potential economic savings, gains in Quality-Adjusted Life-Years (QALY), and reductions in waiting times.
URI: https://bura.brunel.ac.uk/handle/2438/30659
DOI: https://doi.org/10.1038/s41433-024-03156-4
ISSN: 0950-222X
Other Identifiers: ORCiD: Tunde Peto https://orcid.org/0000-0001-6265-0381
ORCiD: Julie Davies https://orcid.org/0000-0002-6875-3100
ORCiD: Pearse Keane https://orcid.org/0000-0002-9239-745X
ORCiD: Lars Holger Ehlers https://orcid.org/0000-0001-6512-5566
Appears in Collections:Brunel Business School Research Papers

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