دورية أكاديمية
Implementing teleophthalmology services to improve cost-effectiveness of the national eye care system.
| العنوان: | Implementing teleophthalmology services to improve cost-effectiveness of the national eye care system. |
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| المؤلفون: | Jørgensen EP; Nordic Institute of Health Economics, Aarhus, Denmark., Muttuvelu DV; Department of Ophthalmology, Copenhagen University Hospital, Copenhagen, Denmark.; 2mitØje ApS, Aarhus, Denmark., Peto T; Queen's University Belfast, Belfast, UK.; Department of Ophthalmology, Odense University Hospital, Odense, Denmark., Natarajan S; Aditya Jyot Eye Hospital Pvt Ltd, Mumbai, Maharashtra, India., Davies J; Global Business School for Health, University College London, London, UK., Keane PA; University College London, London, UK.; NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK., Ehlers LH; Nordic Institute of Health Economics, Aarhus, Denmark. lars@nih-economics.dk. |
| المصدر: | Eye (London, England) [Eye (Lond)] 2024 Oct; Vol. 38 (14), pp. 2788-2795. Date of Electronic Publication: 2024 Jun 04. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8703986 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5454 (Electronic) Linking ISSN: 0950222X NLM ISO Abbreviation: Eye (Lond) Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2003->: London : Nature Publishing Group Original Publication: [London : Ophthalmological Society of the United Kingdom, 1987- |
| مواضيع طبية MeSH: | Cost-Benefit Analysis* , Telemedicine*/economics , Referral and Consultation*/economics , Ophthalmology*/economics , Ophthalmology*/organization & administration , Optometry*/economics , Optometry*/organization & administration , Quality-Adjusted Life Years*, Humans ; Denmark ; Eye Diseases/economics ; Eye Diseases/diagnosis ; Eye Diseases/therapy ; Health Care Costs |
| مستخلص: | Background and Purpose: Optometrist-assisted and teleophthalmology-enabled referral pathway (OTRP) for community optometry referrals has the potential to improve the capacity and efficiency of eye care delivery systems through risk stratification and limiting the number of improved referrals. This study investigates the expected future costs and benefits of implementing OTRP under various possible organizational set-ups relevant to a Danish context. Methods: A decision-analytic model (decision tree) with a one-year time horizon was constructed to portray alternative future patient referral pathways for people examined in optometry stores for suspected ocular posterior segment eye disease. The main outcomes were total healthcare costs per patient, average waiting time from eye examination in store until the start of treatment or end of referral pathway, and quality-adjusted life-years (QALY) gained. The economic evaluation compares the general ophthalmologist referral pathway (GO-RP) with a potential reimbursement model for the optometrist-assisted teleophthalmology referral pathways (R-OTRP) and a procurement model for the optometrist-assisted teleophthalmology referral pathways (P-OTRP). Results: The cost per individual with suspected ocular posterior segment eye disease was estimated to be £116 for GO-RP and £75 and £94 for P-OTRP and R-OTRP respectively. The average waiting time for diagnosis or end of referral pathway was 25 weeks for GO-RP and 5.8 and 5.7 for P-OTPR and R-OTPR respectively. QALY gain was 0.15 for P-OTRP/R-OTRP compared to 0.06 for GO-RP. Conclusion: OTRP is effective in reducing unnecessary referrals and waiting times, increasing patients' HRQoL, and decreasing the costs of diagnosing individuals with suspected ocular posterior segment eye disease. (© 2024. The Author(s).) |
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| تواريخ الأحداث: | Date Created: 20240604 Date Completed: 20240926 Latest Revision: 20240929 |
| رمز التحديث: | 20240929 |
| مُعرف محوري في PubMed: | PMC11427588 |
| DOI: | 10.1038/s41433-024-03156-4 |
| PMID: | 38834842 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1476-5454 |
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| DOI: | 10.1038/s41433-024-03156-4 |