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Glaucoma screening. A cost-effectiveness analysis.

L K Gottlieb, B Schwartz, S G Pauker

    Survey of Ophthalmology
    |November 1, 1983
    PubMed
    Summary
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    Glaucoma screening is likely cost-effective for high-risk groups, using targeted tests and improving follow-up care. This optimizes resource allocation for better vision outcomes.

    Area of Science:

    • Ophthalmology
    • Health Economics
    • Public Health

    Background:

    • Glaucoma screening, diagnosis, and treatment involve significant medical care costs.
    • Evaluating the cost-effectiveness of glaucoma screening is crucial for efficient resource allocation.
    • Existing screening policies may require adjustments to maximize cost-effectiveness.

    Purpose of the Study:

    • To model and evaluate the cost-effectiveness of glaucoma screening strategies.
    • To compare the costs of screening efforts against the benefits of saved quality-adjusted vision years.
    • To identify optimal screening approaches for different population subgroups.

    Main Methods:

    • Utilized economic principles of cost-effectiveness analysis.
    • Developed an intricate model of glaucoma screening, diagnosis, and treatment processes.

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  • Incorporated data on diagnostic test accuracy, disease natural history, and treatment effectiveness.

    • Main Results:

    • Glaucoma screening appears cost-effective when targeted at specific high-risk populations (e.g., Black individuals, diabetics, family history).
    • Combinations of screening tests are more cost-effective than single-test screening for the general population.
    • Specific tests like tonometry (younger populations), ophthalmoscopy (older adults), and automated perimetry (very elderly) show varying cost-effectiveness.

    Conclusions:

    • Targeted glaucoma screening and improved follow-up/compliance strategies are likely more cost-effective than general screening.
    • Resource allocation should consider tailored screening approaches based on age and risk factors.
    • Optimizing screening policies can enhance the efficient allocation of resources in glaucoma management.