Continuous computer simulation analysis of the cost-effectiveness of screening and treating diabetic retinopathy.
This paper analyzes the cost-effectiveness of screening and treating diabetic retinopathy (DR) by simulating the disease progress continuously with existing data. A new computer simulation based on Monte Carlo techniques and logistic transformation follows cohorts from diabetes onset until death in five care scenarios. For younger-onset patients, ophthalmic care reduces the prevalence of blindness by 52% or greater while savings in disability facilities and production losses surpass direct costs. For older-onset patients, less favorable results appear. Financial benefits surpass costs for juvenile-onset patients. For other patients, the net costs of ophthalmic care seem lower than in other health care programs.
Crijns
H
H
Erasmus University.
Casparie
A F
AF
Hendrikse
F
F
D001766:Blindness / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000191:economics; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics; D003930:Diabetic Retinopathy / Q000150:complications / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006801:Humans; D008028:Light Coagulation / Q000191:economics; D016015:Logistic Models; D008269:Macular Edema / Q000150:complications / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000601:surgery; D008297:Male; D017059:Models, Econometric; D009010:Monte Carlo Method; D015995:Prevalence; D012680:Sensitivity and Specificity