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Dollars and Sense



Economic impact of Eye Care

Economic impact of Eye Care



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    Dollars and Sense Dollars and Sense Presentation Transcript

    • 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
    • Purpose
      • Develop a model of the economic impact of vision loss in Australia
    • 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
    • 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
    • Prevalence and Causes of Vision Loss Amount of vision loss and eye disease increases dramatically with increasing age (2004)
    • Prevalence and Causes of Vision Loss Prevalence of blindness (≤20/200 in better eye) Prevalence of low vision (<20/40 in better eye)
    • 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
    • Prevalence and Causes of Vision Loss Australia in 2004 Age > 40 Causes of blindness (≤20/200) Causes of visual impairment (<20/40)
    • 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
    • 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
    • Costs of Vision Loss (2006) Vision loss ranks as the 6 th most important cause of disability worldwide
    • 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
    • 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
    • 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
    • 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
    • Costs of Vision Loss Australia could save 5 dollars for each dollar spent
    • 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
    • Discussion
      • The Australian government committed 14 million to eye health promotion in the May 2006 budget