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A cost-benefit analysis of vision screening methods for preschoolers and school-age children
Vijay N Joish1, Daniel C Malone, Joseph M Miller
1Department of Pharmacy Practice and Sciences, College of Pharmacy, The University of Anzona, Tucson 85721-0284, USA.
Insights
Visual acuity screening (VAS) and photoscreening (PS) in children both offer benefits exceeding costs. Photoscreening in 3- to 4-year-olds yielded the highest net benefit, making it a cost-effective strategy for early vision detection.
Area of Science:
- Ophthalmology
- Public Health
- Health Economics
Background:
- Early detection of vision impairments in children is crucial for development.
- Visual acuity screening (VAS) and photoscreening (PS) are common methods for vision assessment in pediatric populations.
Purpose of the Study:
- To compare the costs and benefits of visual acuity screening (VAS) and photoscreening (PS) in children.
- To identify the most cost-effective screening method across different pediatric age groups.
Main Methods:
- A societal-decision analytic model was employed to compare VAS and PS.
- Data on sensitivity, specificity, prevalence, costs, and referral rates were integrated from literature and databases.
- Analyses were conducted for three age groups: 6-18 months, 3-4 years, and 7-8 years.
Main Results:
- All screening methods demonstrated benefit-to-cost ratios greater than 1.0.
- Photoscreening (PS) in 3- to 4-year-olds showed the highest total net benefit ($19,412).
- Sensitivity and specificity of the screening tools were key factors influencing cost-effectiveness.
Conclusions:
- Photoscreening (PS) in 3- to 4-year-old children provides a greater net benefit than other evaluated screening methods and age groups.
- The study supports PS as a highly cost-beneficial approach for preschool vision screening.
Introduction:
The purpose of this study was to determine costs and benefits of visual acuity screening (VAS) or photoscreening (PS) in children.
Methods:
A societal-perspective, decision-analytic model compared VAS and PS conducted in three age groups: children 6 to 18 months, 3 to 4 years, and 7 to 8 years old. Literature estimates of sensitivity, specificity, and prevalence were used. Cost estimates and referral rates for surgical treatment were derived from a managed care database and the United States Social Security Administration.
Results:
All the benefit-to-cost ratios exceeded 1.0, meaning that all screening programs studied had benefits that exceeded the cost of screening. The total net benefit was highest for PS in children of 3 to 4 years of age (19,412 US dollars) and the least for VAS in children 7 to 8 years of age (15,179 US dollars). The benefit-to-cost ratio was highest for the VAS in children 3 to 4 years of age (162 US dollars) and least for PS in infants 6 to 18 month old (140 US dollars). Sensitivity of the PS instrument and VAS charts were the most influential variables in determining the most cost-beneficial program.
Conclusions:
Based on the best available data, the net benefit of PS in 3 to 4 year old preschool children is greater than VAS in children 7 to 8 years of age, PS in toddlers, and VAS in children 3 to 4 years of age.
