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Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
Dollars and Sense
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Dollars and Sense


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Economic impact of Eye Care

Economic impact of Eye Care

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  • 1. Eye Care: Dollars and Sense Taylor HR. Am J Ophthalmol 2007; 143:1-8. Journal Club Terry J. Alexandrou, MD Department of Ophthalmology and Visual Science University of Chicago
  • 2. Purpose
    • Develop a model of the economic impact of vision loss in Australia
  • 3. Design
    • Data obtained from:
      • Population based epidemiologic studies of eye disease
      • Studies of the impact of vision loss on daily living
      • Australian national health-care costs
      • Census
      • Demographic projections
    • Data used to assess the current magnitude and costs of vision loss and to make projections as to future costs
  • 4. Population Based Evidence
    • Melbourne Visual Impairment Project (VIP)
      • Large, population based survey
      • Purpose:
        • Determine the prevalence and causes of vision loss
        • Examine the risk factors for vision loss
        • Identify barriers to the provision of eye care
      • 5 years to complete survey
      • Included urban, rural, and institutionalized populations rather than those from a single geographic location
      • Minorities represented in similar proportions to national average
      • Similar to other large pop studies (Beaver Dam, ect.), however did not exclude based on age
  • 5. Prevalence and Causes of Vision Loss Amount of vision loss and eye disease increases dramatically with increasing age (2004)
  • 6. Prevalence and Causes of Vision Loss Prevalence of blindness (≤20/200 in better eye) Prevalence of low vision (<20/40 in better eye)
  • 7. Prevalence and Causes of Vision Loss (US in 1909) Ophthalmia neonatum and injury were leading causes of blindness 100 years ago, when life expectancy was ~40 years
  • 8. Prevalence and Causes of Vision Loss Australia in 2004 Age > 40 Causes of blindness (≤20/200) Causes of visual impairment (<20/40)
  • 9. Impact of Vision Loss
    • Critical level of vision is that level usually required for an unrestricted drivers license
    • People with VA < 20/40 have sig. increased risk of:
      • Falls 28,29
      • Hip fractures 30,31
      • Depression 32,33
      • Loss of social independence 34,35
      • Likely to be admitted to nursing homes 3 years earlier than those with normal vision 36
  • 10. Costs of Vision Loss Australia Vision loss is the 7 th leading cause of disability in Australia Causes nearly 3% of the national total of years of life lost attributable to disability
  • 11. Costs of Vision Loss (2006) Vision loss ranks as the 6 th most important cause of disability worldwide
  • 12. Costs of Vision Loss Australia(2004) Total cost of vision loss was ~10 billion Indirect costs - ~3.2 billion ● loss of earnings ● cost of caregivers ● additional age care Loss of well-being - ~4.8 billion Lost income - ~1.8 billion Direct costs - ~1.9 billion ● hospital care ● outpatient and office visits ● optometry costs ● medications
  • 13. Costs of Vision Loss Direct Health Costs for vision disorders ranks 7 th in Australian rankings Cataract surgery is the single largest condition cost 180,000 cataract surgeries performed in Australia in 2005
  • 14. Costs of Eye Care
    • WHO considers intervention to be cost-effective if it costs less than 3x GDP per capita to avert 1 lost quality adjusted life year (QALY)
      • In Australia - < $112,000 per QALY
    • Very cost effective : < 1 GDP per capita
      • In Australia - < $37,000 per QALY
    • Cataract surgery : < $3,000 per QALY
    • Diabetic Retinopathy Screening: < $20,000 per QALY
  • 15. Costs of Vision Loss
    • Authors propose 3 measures to reverse the projected increase in the prevalence, economic costs, and loss of well-being associated with vision loss
    • 1) Prevention
    • 2) Provide adequate funding for eye care services for treatable eye conditions
    • 3) Substantial increase in funding for targeted research into
  • 16. Costs of Vision Loss Australia could save 5 dollars for each dollar spent
  • 17. Discussion
    • This data on the health economic impact of vision loss will be useful in helping to argue the importance of eye care to policy-makers
    • Provides data required to place the needs for eye care in perspective and to compare it with other health priorities
    • This data is specific for Australia, but may provide some information into the situations in the U.S and other developed countries
  • 18. Discussion
    • The Australian government committed 14 million to eye health promotion in the May 2006 budget