Related Experiment Video
Updated: Aug 2, 2025
Cell-based Assay Protocol for the Prognostic Prediction of Idiopathic Scoliosis Using Cellular Dielectric Spectroscopy
Published on: October 16, 2013
Cost Analysis of Orthoptist-Led Neurofibromatosis Type 1 Screening Clinics
Navdeep Kaur1, Catherine Lewis1, Sandra Staffieri1,2,3
1Department of Ophthalmology, The Royal Children's Hospital, Victoria, AU.
Insights
Orthoptist-led clinics are a more cost-efficient model for screening children with neurofibromatosis Type 1 (NF1) for optic pathway gliomas (OPGs). This approach significantly reduces appointment time and cost compared to consultant-led clinics.
Area of Science:
- Ophthalmology
- Genetics
- Health Economics
Background:
- Neurofibromatosis Type 1 (NF1) is a genetic disorder associated with an increased risk of optic pathway gliomas (OPGs).
- Regular screening for OPGs is crucial in children with NF1 to enable early detection and intervention.
- Current screening models often involve consultant-led clinics, which may have significant associated costs.
Purpose of the Study:
- To compare the cost-efficiency of orthoptist-led versus consultant-led clinics for OPG screening in children with NF1.
- To analyze the resource utilization and associated costs of each screening model.
Main Methods:
- A costing study was conducted at the Royal Children's Hospital, Melbourne.
- Data on patient time spent with healthcare professionals were collected using workflow management software.
- A bottom-up micro-costing approach and bootstrap simulations were employed to estimate appointment costs and confidence intervals.
Main Results:
- Analysis included 130 consultant-led and 234 orthoptist-led clinic appointments.
- Orthoptist-led clinics demonstrated significantly shorter mean appointment times (25.85 minutes) compared to consultant-led clinics (45.11 minutes).
- The mean cost per appointment was substantially lower in orthoptist-led clinics (A $20.40) versus consultant-led clinics (A $84.15), representing a saving of A $63.75 per appointment.
Conclusions:
- Orthoptist-led clinics represent a more cost-efficient model for ophthalmic screening of OPGs in children with NF1.
- This model optimizes resource allocation and reduces healthcare expenditure without compromising screening quality.
Purpose:
To conduct a costing study comparing orthoptist-led with consultant-led clinics screening for optic pathway gliomas (OPGs) in children with neurofibromatosis Type 1 (NF1) attending the Royal Children's Hospital (RCH), Melbourne.
Methods:
Patients with NF1 examined in the orthoptist-led NF1 screening clinic and/or consultant-led clinics during the study period were identified. The workflow management software Q-Flow 6® provided data documenting patient's time spent with the orthoptist, nurse, and ophthalmologist. Time points were converted into minutes and multiplied by the cost-per-minute for each profession. A bottom-up micro-costing approach was used to estimate appointment level costs. Bootstrap simulations with 1000 replications were used to estimate 95% confidence intervals (CIs) for the difference in mean appointment time and cost between clinics.
Results:
Data for 130 consultant-led clinic appointments and 234 orthoptist-led clinic appointments were extracted for analysis. The mean time per appointment for the consultant-led clinic was 45.11 minutes, and the mean time per appointment for the orthoptist-led clinic was 25.85 minutes. The mean cost per appointment for the consultant-led clinic was A $84.15 (GBP £39.60) compared to the orthoptist-led clinic at A $20.40 (GBP £9.60). This represents a mean reduction of 19.25 minutes per appointment (95% CI, -24.85 to -13.66) and a mean reduction of A $63.75 (GBP £30.00) per appointment (95% CI, (A $-75.40 to $-52.10 [GBP £ -35.48 to £ -24.52]).
Conclusion:
An orthoptist-led clinic screening for OPGs in patients with NF1 can be a more cost-efficient model of care for ophthalmic screening in this patient group.
