Comparing costs of monitoring glaucoma patients: hospital ophthalmologists versus community optometrists.
OBJECTIVE
To compare the costs of monitoring stable glaucoma patients by community optometrists and hospital ophthalmologists.


METHODS
A cost analysis was conducted alongside a randomised controlled trial which compared the accuracy and acceptability of measurement in each form of care. The viewpoints of the health service and of patients were considered. Costs were assessed using a number of different methods. Sensitivity analysis was conducted for key variables.


RESULTS
The baseline analysis reflected heavily the different length of time between follow-up in the two arms of the trial (10 months (average) for hospital, 6 months for optometrists). It showed annual cost per patient for hospital ophthalmologists varied from 14.50 pounds to 59.95 pounds, and community optometrist costs varied from 68.98 pounds to 108.98 pounds. Assuming a 6-month follow-up interval for the hospital ophthalmologists, costs varied from 24.16 pounds to 99.92 pounds.


CONCLUSIONS
Recommendations about the least costly form of follow-up must depend on the context in which the decision is being taken and the scale of change envisaged. If the aim is to recoup resources from hospitals in order to pay for monitoring in the community, community monitoring is unlikely to be the least costly option.
Coast
J
J
Department of Social Medicine, University of Bristol, UK.
Spencer
I C
IC
Smith
L
L
Spry
P G
PG
D003153:Community Health Services / Q000191:economics; D003361:Cost Allocation; D005251:Fees, Medical; D005901:Glaucoma / Q000191:economics* / Q000628:therapy; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017721:Hospital Costs; D006748:Hospital Departments / Q000191:economics; D006801:Humans; D009885:Ophthalmology / Q000191:economics*; D009907:Optometry / Q000191:economics*; D011795:Surveys and Questionnaires; D006113:United Kingdom