Original articleThe Cost–Utility of Telemedicine to Screen for Diabetic Retinopathy in India
Section snippets
Study Setting and Program Description
The study was undertaken in rural Tamil Nadu, Southern India. A recent survey in rural Tamil Nadu estimated the diabetes prevalence at 7.8% among people aged ≥20 years.16
The Sankara Nethralaya Medical Research Foundation teleophthalmology program conducts DR screening camps in villages in the rural districts neighboring Chennai. In the current program, 1-off screening (i.e., screening offered once) is conducted in each village rather than diabetic persons being invited for screening repeatedly
Model Parameters
Table 1 shows the per-person costs of telescreening, hospital retinal examinations, and laser photocoagulation treatment from the health provider and societal perspective. The health provider costs of telescreening were $7.36 per person screened, and the societal costs (i.e., including direct and indirect household costs) were $9.38. Costs for retinal examination and a single laser photocoagulation treatment at the hospital were $5.84 and $7.51 per person, respectively, from the health provider
Discussion
Our cost–utility model suggests that from a health provider perspective, the current Sankara Nethralaya rural teleophthalmology screening program is cost-effective compared with no DR screening for rural diabetic patients if the World Health Organization–suggested threshold (1–3 times the Indian GDP) is used to define cost-effectiveness.18, 19 Increasing the screening frequency to provide screening at regular intervals would increase the costs of the program; however, the increased QALYs gained
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Strategies for cataract and uncorrected refractive error case finding in India: Costs and cost-effectiveness at scale
2022, The Lancet Regional Health - Southeast AsiaVirtual reality and augmented reality— emerging screening and diagnostic techniques in ophthalmology: A systematic review
2022, Survey of OphthalmologyCitation Excerpt :Telemedicine breaks the geographical barriers and hence makes distribution of health care service more efficient and equitable.22 As a diagnostic modality for diabetic retinopathy, telemedicine is used in the United States and was proven cost-effective in a developing country setting.38,43 It may also improves access to cytomegalovirus retinitis screening, a debilitating condition found most commonly in immunocompromised patients.43
Measuring the cost-effectiveness of using telehealth for diabetes management: A narrative review of methods and findings
2022, International Journal of Medical InformaticsCitation Excerpt :Several methods were used to calculate cost-effectiveness (Table 3). Markov model was the leading method [17,36,31], or a combination of a Markov model with other models [9,43,26]. Decision trees were used as well [10] with some additional methods such as Excel-based decision tree models [28] and deep learning systems (DLS) combined with a decision tree model [51].
Cost-effectiveness and cost-utility of traditional and telemedicine combined population-based age-related macular degeneration and diabetic retinopathy screening in rural and urban China
2022, The Lancet Regional Health - Western PacificCitation Excerpt :Utilities were assumed to be 1 for participants without AMD and DR,12 0·97 for those with early AMD,10 0·85 for those with GA,10 and 0·57 for those with NVAMD.10 Patients with non-STDR were assumed to have a utility value of 0·87,8 and patients with DME and STDR were assumed to have utility values of 0·83 and 0·7,4,8 respectively. Patients with blindness were assumed to have a utility value of 0·26.12
Manuscript no. 2012-634.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
This study was funded by a grant from Sightsavers. The funding organization had no role in the design or conduct of this research.