Remote Eye Triage: Health Economic Perspectives on Resource Prioritization.

IF 2.5 Q2 HEALTH CARE SCIENCES & SERVICES
Health Services Insights Pub Date : 2025-06-26 eCollection Date: 2025-01-01 DOI:10.1177/11786329251347684
Casper van der Zee, Robert P L Wisse, Saskia M Imhof, Miriam P van der Meulen
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引用次数: 0

Abstract

Background: The TeleTriageTeam (TTT) is a novel system for remote eyecare delivery.

Objectives: Explores the impact of TTT on costs by depicting program theory of care prioritization. Moreover, a quantification of longer-term effects of delay (and inversely earlier treatment) on costs is performed.

Design: Mixed-methods health economic evaluation.

Methods: First, we depicted the program theory of prioritization into a LOGIC-model using existing TTT-data and expert interviews outlining the causal pathways how and why a program is expected to work. Second, we identified the most relevant key diagnoses to be appraised based on incidence, severity, and presumed triage impact. Third, we estimated the impact of delay (or inversely earlier treatment) on societal costs and quality of life (QoL) based on literature searches. Cost data were updated to 2023. Results were reported per delayed patient per 6 months (the average TTT delay).

Results: Five key diagnoses were selected: cataract, diabetic retinopathy (DRP), age-related macular disease (AMD), glaucoma, and dry-eye-syndrome (DES). The LOGIC-model showed how the TTT actions could influence costs and QoL. Semi-structured interviews revealed delay results in adverse events, at the expense of shorter waiting times in prioritized patients, and overall decreases personnel burden. Reduced waiting times were also believed to decrease burden and costs in prioritized patients. Literature showed that a delay in glaucoma treatment results in savings (-€409), while the other diagnoses suggested higher societal costs (cataract €3298, DES €2156, AMD €1455, DRP €117). QoL reduction and increased costs due to delay were more apparent when delay results in longer duration of curable symptoms compared to delay in stable disease (up to 0.09 vs 0.003 QALYs and €3298 vs €1455, respectively).

Conclusions: Eye care delay results reduced QoL and increased societal costs, yet this is compounded by gains attributable to justified prioritization of more urgent and more severe patients.

远程眼科分诊:资源优先排序的卫生经济观点。
背景:TeleTriageTeam (TTT)是一种新型的远程眼科护理系统。目的:通过描述护理优先级的程序理论,探讨TTT对成本的影响。此外,还对延迟治疗(以及相反的早期治疗)对成本的长期影响进行了量化。设计:混合方法卫生经济评价。方法:首先,我们利用现有的ttt数据和专家访谈,将优先排序的计划理论描述为逻辑模型,概述了计划如何以及为什么预期会起作用的因果途径。其次,我们确定了最相关的关键诊断,以评估基于发病率,严重程度和假定的分诊影响。第三,我们根据文献检索估计延迟(或相反的早期治疗)对社会成本和生活质量(QoL)的影响。成本数据更新到2023年。每6个月报告每名延迟患者的结果(平均TTT延迟)。结果:选择5个关键诊断:白内障、糖尿病视网膜病变(DRP)、老年性黄斑病变(AMD)、青光眼和干眼综合征(DES)。逻辑模型显示了TTT行动如何影响成本和生活质量。半结构化访谈显示,延误会导致不良事件,以减少优先患者的等待时间为代价,总体上减轻了人员负担。减少等待时间也被认为可以减轻优先患者的负担和费用。文献显示,延迟青光眼治疗可节省费用(- 409欧元),而其他诊断则意味着更高的社会成本(白内障3298欧元,DES 2156欧元,AMD 1455欧元,DRP 117欧元)。与稳定疾病的延迟相比,当延迟导致可治愈症状持续时间更长时,延迟导致的生活质量降低和成本增加更为明显(分别高达0.09对0.003质量aly和3298欧元对1455欧元)。结论:眼科护理延迟导致生活质量降低,社会成本增加,但这与合理优先考虑更紧急和更严重的患者的收益相结合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health Services Insights
Health Services Insights HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.60
自引率
0.00%
发文量
47
审稿时长
8 weeks
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