Cost and detection rate of glaucoma screening with imaging devices in a primary care center
Antón López, Alfonso (Institut Català de la Retina)
Fallon, Monica (Universitat Autònoma de Barcelona)
Cots Reguant, Francesc (Parc de Salut Mar. Servei d'Estudis)
Sebastian, María A. (Institut Català de la Salut. Centre d'Assistència Primària Larrard (Barcelona, Catalunya))
Morilla-Grasa, Antonio (Institut Català de la Retina)
Mojal, Sergi (Institut Hospital del Mar d'Investigacions Mèdiques)
Castells, Xavier (Parc de Salut Mar. Servei d'Estudis)

Date:	2017
Abstract:	To analyze the cost and detection rate of a screening program for detecting glaucoma with imaging devices. In this cross-sectional study, a glaucoma screening program was applied in a population-based sample randomly selected from a population of 23,527. Screening targeted the population at risk of glaucoma. Examinations included optic disk tomography (Heidelberg retina tomograph [HRT]), nerve fiber analysis, and tonometry. Subjects who met at least 2 of 3 endpoints (HRT outside normal limits, nerve fiber index ≥30, or tonometry ≥21 mmHg) were referred for glaucoma consultation. The currently established ("conventional") detection method was evaluated by recording data from primary care and ophthalmic consultations in the same population. The direct costs of screening and conventional detection were calculated by adding the unit costs generated during the diagnostic process. The detection rate of new glaucoma cases was assessed. The screening program evaluated 414 subjects; 32 cases were referred for glaucoma consultation, 7 had glaucoma, and 10 had probable glaucoma. The current detection method assessed 677 glaucoma suspects in the population, of whom 29 were diagnosed with glaucoma or probable glaucoma. Glaucoma screening and the conventional detection method had detection rates of 4. 1% and 3. 1%, respectively, and the cost per case detected was 1,410 and 1,435€, respectively. The cost of screening 1 million inhabitants would be 5. 1 million euros and would allow the detection of 4,715 new cases. The proposed screening method directed at population at risk allows a detection rate of 4. 1% and a cost of 1,410 per case detected.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Screening ; Glaucoma ; Cost ; Imaging devices ; Detection rate
Published in:	Clinical Ophthalmology (Auckland, N.Z.), Vol. 11 (february 2017) , p. 337-346, ISSN 1177-5483

DOI: 10.2147/OPTH.S120398
PMID: 28243057

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