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Cost-Effectiveness of a Telemedicine Optometric-Based Assessment for Screening Diabetic Retinopathy in a Country with a Universal Public Health System.
Ortiz-Toquero, Sara; Aleixandre, Guillermo; Valpuesta, Yolanda; Perez Fernandez, Cristina; de la Iglesia, Purificación; Pastor, Jose Carlos; Lopez-Galvez, Maribel.
Afiliación
  • Ortiz-Toquero S; IOBA Eye Institute, University of Valladolid, Valladolid, Spain.
  • Aleixandre G; Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain.
  • Valpuesta Y; Department of Applied Economics, University of Valladolid, Valladolid, Spain.
  • Perez Fernandez C; Medina de Rioseco Healthcare Center, Salud Castilla y León, Medina de Rioseco, Spain.
  • de la Iglesia P; Department of Ophthalmology, University Clinic Hospital of Valladolid, Valladolid, Spain.
  • Pastor JC; Regional Ministry of Health (Dirección General de Asistencia Sanitaria, Consejería de Sanidad), Valladolid, Spain.
  • Lopez-Galvez M; IOBA Eye Institute, University of Valladolid, Valladolid, Spain.
Telemed J E Health ; 2024 Jul 31.
Article en En | MEDLINE | ID: mdl-39082066
ABSTRACT

Objective:

To determine the cost-effectiveness of a new telemedicine optometric-based screening program of diabetic retinopathy (DR) compared with traditional models' assessments in a universal European public health system.

Methods:

A new teleophthalmology program for DR based on the assessment of retinographies (3-field Joslin Vision Network by a certified optometrist and a reading center [IOBA-RC]) was designed. This program was first conducted in a rural area 40 km from the referral hospital (Medina de Rioseco, Valladolid, Spain). The cost-effectiveness was compared with telemedicine based on evaluations by primary care physicians and general ophthalmologists, and to face-to-face examinations conducted by ophthalmologists. A decision tree model was developed to simulate the cost-effectiveness of both models, considering public and private costs. The effectiveness was measured in terms of quality of life.

Results:

A total of 261 patients with type 2 diabetes were included (42 had significant DR and required specific surveillance by the RC; 219 were undiagnosed). The sensitivity and specificity of the detection of DR were 100% and 74.1%, respectively. The telemedicine-based DR optometric screening model demonstrated similar utility to models based on physicians and general ophthalmologists and traditional face-to-face evaluations (0.845) at a lower cost/patient (€51.23, €71.65, and €86.46, respectively).

Conclusions:

The telemedicine-based optometric screening program for DR in a RC demonstrated cost savings even in a developed country with a universal health care system. These results support the expansion of this kind of teleophthalmology program not only for screening but also for the follow-up of diabetic patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Telemed J E Health Asunto de la revista: INFORMATICA MEDICA / SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Telemed J E Health Asunto de la revista: INFORMATICA MEDICA / SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos