279872
Cost assessment of diabetic retinopathy screening in a community setting
Tuesday, November 5, 2013
: 11:30 a.m. - 11:45 a.m.
Margaret Byrne, PhD,
Dept. of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Byron Lam, MD,
Bascom Palmer Eye Institute, University of Miami, Miami, FL
Dorothy F. Parker, MHS,
Jay Weiss Institute for Health Equity, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
Manuel A. Ocasio, MSPH,
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
Jenelle Lin, BS,
Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
David J. Lee, PhD,
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
Purpose: To assess the costs associated with a community-based program to screen adults for diabetic retinopathy. Methods: Free screening for diabetic retinopathy and visual acuity was offered to adult diabetics at a community health center in a low socioeconomic area of Miami-Dade County. If fundus photos showed abnormalities, referrals were made for follow-up care. Data were collected on start-up costs (e.g., capital equipment) and continuing costs (e.g., personnel, fees for reading retinal scans, supplies). Total costs, cost per person screened and per referral were calculated. Different assumptions for cost distributions and the life-span of capital equipment were made for sensitivity analyses. Results: In the first 9 months, 477 adults were screened: 44% blacks, 55% Hispanics, and 64% women. The average age of participants was 55.8 (sd=9.5). The average time since diagnosed with diabetes was 9.6 years (sd=8.3). Most (79%) had no health insurance, 44% had no eye exam in the last 2 years, and 10% had never had an eye exam. Referrals were made for 121 abnormal scans. Total intervention cost to-date was $85,714. Distributing start-up costs among all participants, cost/screening was $179 and cost/referral $708. Assuming that all equipment will last 3 (5) years, the estimated cost/screening was $135 ($129) and cost/referral $531 ($507). Conclusions: Most participants had no health insurance nor a recent eye exam, and 25% needed referrals, demonstrating the need for the screening program. The program's relatively low-cost illustrates that such a community-based intervention could be widely adopted.
Learning Areas:
Administer health education strategies, interventions and programs
Learning Objectives:
Describe the methodology for cost assessment in a community based vision screening program.
Compare the costs per participant and per referral under different assumptions about the capital equipment life-span.
Discuss the importance of a community based program of diabetic retinopathy screening in a high-needs, low resource community
Keyword(s): Community Preventive Services, Vision Care
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am qualified to ba an abstract author because I am a co-investigator on this grant providing expertise in cost analysis an health economics.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
