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Economic evaluation of orthoptic screening: results of a field study in 121 German kindergartens
Hans-Helmut König1, Jean-Cyriaque Barry, Reiner Leidl
1Department of Health Economics, University of Ulm, Ulm, Germany. hans-helmut.koenig@mathematik.uni-ulm.de
Insights
This study evaluated the cost-effectiveness of orthoptic screening for young children in German kindergartens. The program identified new cases of amblyopia and related conditions at a cost of 924 Euro per detected case.
Area of Science:
- Ophthalmology
- Public Health
- Health Economics
Background:
- Preschool vision screening is crucial for early detection of amblyopia and amblyogenic factors.
- Orthoptic screening programs aim to identify visual impairments in young children before they impact long-term vision.
- Understanding the economic viability of such programs is essential for healthcare providers and policymakers.
Purpose of the Study:
- To analyze the cost-effectiveness of an established orthoptic screening program implemented in German kindergartens.
- To determine the financial investment required for identifying specific visual conditions in preschool-aged children.
Main Methods:
- An empirical cost-effectiveness analysis was performed on a field study involving 1180 three-year-old children across 121 kindergartens.
- Direct costs were calculated from a third-party payer perspective, including labor, materials, and travel.
- Effectiveness was measured by the number of newly diagnosed cases of amblyopia and amblyogenic factors.
Main Results:
- The average cost per screening examination was 12.58 Euro, with labor costs comprising the majority.
- The total cost for screening 1180 children was 21,253 Euro, detecting 23 new cases of target conditions.
- The cost-effectiveness ratio was determined to be 924 Euro per detected case, influenced by screening prevalence and specificity.
Conclusions:
- The cost-effectiveness data provides valuable insights for third-party payers like health insurance and public health services.
- Findings can inform decisions regarding the organization and financing of preschool vision-screening initiatives.
- The study highlights the economic considerations for implementing widespread orthoptic screening programs.
Purpose:
The purpose of this study was to analyze the cost-effectiveness of an orthoptic screening program in kindergarten children.
Methods:
An empiric cost-effectiveness analysis was conducted as part of a field study of orthoptic screening. Three-year-old children (n = 1180) in 121 German kindergartens were screened by orthoptists. The number of newly diagnosed cases of amblyopia and amblyogenic factors (target conditions) was used as the measure of effectiveness. The direct costs of orthoptic screening were calculated from a third-party-payer perspective based on comprehensive measurement of working hours and material costs.
Results:
The average cost of a single orthoptic screening examination was 12.58 Euro. This amount consisted of labor costs (10.99 Euro) and costs of materials and traveling (1.60 Euro). With 9.9 children screened on average per kindergarten, average labor time was 279 minutes per kindergarten, or 28 minutes per child. It consisted of time for organization (46%), traveling (16%), preparing the examination site (10%), and the orthoptic examination itself (28%). The total cost of the screening program in all 121 kindergartens (including ophthalmic examination, if required) was 21,253 Euro. Twenty-three new cases of the target conditions were detected. The cost-effectiveness ratio was 924 Euro per detected case. Sensitivity analysis showed that the prevalence and the specificity of orthoptic screening had substantial influence on the cost-effectiveness ratio.
Conclusions:
The data on the cost-effectiveness of orthoptic screening in kindergarten may be used by such third-party payers as health insurance or public health services when deciding about organizing and financing preschool vision-screening programs.
