Cost-Effectiveness Analysis of a Regional Program for Identifying and Treating Children with Correctable Refractive Error in Indonesia.

IF 1.7 4区 医学 Q3 OPHTHALMOLOGY Ophthalmic epidemiology Pub Date : 2024-08-01 Epub Date: 2023-10-05 DOI:10.1080/09286586.2023.2266831
Rahul S Iyengar, Michael Krautmann, Satyaprabha Kotha, John Macom, Nick Kourgialis, Joshua R Ehrlich
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Abstract

Purpose: Indonesia is a rapidly growing county with over 262 million inhabitants, but among highly populated countries it has one of the lowest concentrations of eye care providers. This study evaluated the cost-effectiveness of a program implemented in South Sulawesi, Indonesia that trained school teachers to conduct vision screenings, organized in-school evaluations by opticians, and provided free eyeglasses to school children with refractive error (RE).

Methods: Schoolteachers across 6 districts in South Sulawesi were trained to screen children with possible RE for subsequent evaluation by opticians. All costs associated with designing and implementing the program (administration, training personnel, labor, service delivery, etc.) were assessed. Expenditures and outcomes data were utilized to calculate the cost per disability-adjusted-life-year (DALY) averted using both 2010 and 2016 Global Burden of Disease (GBD) weights.

Results: 521 teachers screened 41,212 students across 172 schools in South Sulawesi. 4,506 (10.9%) students failed screening, 2,652 were seen by optometrists, and 2,038 received glasses.The total program cost was US$97,380, with glasses (39.6%) and labor (23.3%) accounting for the two biggest expenditures. In districts with school-based refraction services, the costs per student screened, refracted, and receiving glasses were $2.57, $31.33, and $41.40, respectively; costs were $2.04, $59.80, and $73.22 when district services were instead provided centrally. The estimated cost per DALY averted was US$89.04 based on GBD 2010 weights.

Conclusion: Treating children with correctable RE in limited resource settings can be done cost-effectively through a school-based model.

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印度尼西亚识别和治疗可矫正屈光不正儿童区域项目的成本效益分析。
目的:印度尼西亚是一个快速发展的县,有2.62亿居民,但在人口稠密的国家中,它是眼科护理人员最集中的国家之一。这项研究评估了在印度尼西亚南苏拉威西实施的一项计划的成本效益,该计划培训学校教师进行视力筛查,由眼镜商组织校内评估,方法:对南苏拉威西省6个区的教师进行培训,对可能患有屈光不正的儿童进行筛查,供眼镜商进行后续评估。评估了与设计和实施该计划相关的所有成本(管理、培训人员、劳动力、服务提供等)。支出和结果数据用于计算使用2010年和2016年全球疾病负担(GBD)权重避免的每个残疾调整生命年(DALY)的成本。结果:521名教师对南苏拉威西172所学校的41212名学生进行了筛查。4506名(10.9%)学生未通过筛查,2652名学生被验光师检查,2038名学生接受了眼镜检查。项目总成本为97380美元,其中眼镜(39.6%)和劳动力(23.3%)占最大的两项支出。在提供学校屈光服务的地区,每位学生筛查、屈光和接受眼镜的费用分别为2.57美元、31.33美元和41.40美元;当地区服务改为集中提供时,成本分别为2.04美元、59.80美元和73.22美元。根据GBD 2010的权重,每DALY避免的估计成本为89.04美元。结论:在资源有限的环境中,通过学校模式可以经济有效地治疗患有可纠正RE的儿童。
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来源期刊
Ophthalmic epidemiology
Ophthalmic epidemiology 医学-眼科学
CiteScore
3.70
自引率
5.60%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.
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