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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