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Remote Eye Triage: Health Economic Perspectives on Resource Prioritization.

Casper van der Zee^1,2,3, Robert P L Wisse^1,4, Saskia M Imhof¹

¹Department of Ophthalmology, University Medical Center Utrecht, The Netherlands.

Health Services Insights

|June 30, 2025

Summary

This summary is machine-generated.

Remote eyecare delivery via TeleTriageTeam (TTT) impacts costs and quality of life. While delays increase societal costs for most conditions, prioritization offers gains, balancing overall economic and patient outcomes.

Keywords:

LOGIC model complex interventions delayed care health economic methods remote eyecare telemedicine

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Area of Science:

Ophthalmology
Health Economics
Health Services Research

Background:

The TeleTriageTeam (TTT) is a novel system designed for remote delivery of eyecare services.
This system aims to improve efficiency and patient outcomes in ophthalmological care.

Purpose of the Study:

To explore the economic impact of the TeleTriageTeam (TTT) system by analyzing its care prioritization strategies.
To quantify the long-term effects of treatment delays versus earlier interventions on healthcare costs and quality of life.

Main Methods:

A mixed-methods health economic evaluation was conducted.
A logic model was developed using TTT data and expert interviews to map causal pathways of the prioritization program.
Key diagnoses (cataract, diabetic retinopathy, age-related macular disease, glaucoma, dry-eye syndrome) were selected based on incidence, severity, and triage impact. Societal costs and quality of life impacts of delays were estimated from literature, with costs updated to 2023.

Main Results:

The logic model illustrated how TTT actions influence costs and quality of life.
Interviews indicated that while delays can cause adverse events, prioritization reduces waiting times and personnel burden.
Delayed glaucoma treatment yielded savings (-€409), but delays for other conditions increased societal costs (cataract €3298, dry-eye syndrome €2156, age-related macular disease €1455, diabetic retinopathy €117). Longer durations of curable symptoms due to delay significantly reduced quality-adjusted life years (QALYs) and increased costs compared to delays in stable disease.

Conclusions:

Delay in eyecare significantly reduces quality of life and increases societal costs.
However, the TTT system's justified prioritization of urgent and severe cases generates benefits that offset some of these negative impacts.
The findings highlight the complex interplay between timely treatment, patient prioritization, and overall economic and quality-of-life outcomes in remote eyecare.