Budget impact analysis of a vision center-based community eye health program in an underserved urban slum in India

We aim to study the Vision Centre-Based Community Eye Health Programs in an underserved urban slum in Pune city, India, using Budget Impact Analysis from a payer's perspective.

Input costs, training, human resources, capital equipment cost, recurrent consumable costs, salaries, and rent were calculated from January 2015 to December 2022. The income earned from subsidized outpatient care, optical services, and surgeries was calculated. The monthly reports of the center were used to calculate the number of beneficiaries. Data were stored in Excel and analyzed in R software. Free surgeries, consultations, and spectacles were distributed to needy patients occasionally during these years.

The Vision Centre at Phulenagar, Vishrantwadi, Pune, in partnership with Operation Eyesight Universal, has been operational since January 2015, providing critical eye health services to the community. Over 5 years, the center examined 44,535 individuals, with 98.1% re-examined in 2019, and significantly reduced the prevalence of blindness and visual impairment. Budget impact analysis revealed the center's establishment cost, net budget impact, and the economic impacts of various operational scenarios. Sensitivity analysis showed that income from surgeries had the highest influence on total income, while spectacle costs affected total costs the most. Scenario analysis highlighted that a combined approach of reducing costs and increasing income, particularly in the absence of District Blindness Control Society subsidy, could improve the financial sustainability of the Vision Centre.

Vision center-based prevention of blindness and vision impairment programs, combined with home screening, is effective clinically and economically.