The economic impact of ophthalmic services for persons with diabetes in the Canadian Province of Nova Scotia: 1993-1996.
OBJECTIVE
If undetected and untreated, diabetic retinopathy can lead to severe vision loss and irreversible blindness, imposing both clinical and economic costs to patients and society. The purpose of this study, therefore, was to determine both the direct and indirect costs of providing ophthalmic, social and rehabilitative services for persons with diabetic eye disease.


METHODS
Persons with diabetes and seen by ophthalmologists in the Canadian Province of Nova Scotia were ascertained from provincial health records for the years 1993-1996, inclusive. In addition, utilization data from community and blindness rehabilitation agencies located throughout the Province of Nova Scotia for the same time period were also obtained and analyzed. A cost-of-illness analysis of ophthalmic and additional services for persons with diabetes was then performed using the available data sources.


RESULTS
The total cost of direct and indirect ophthalmic, disability and rehabilitative care for persons with diabetes mellitus in Nova Scotia over the study period, 1993-1996, was estimated to be CDN $10,521,816.58. Direct costs amounted to CDN $1,416,355.05 (13.46%), indirect costs due to lost productivity reached CDN $5,072,831.85 (48.22%), rehabilitation services cost CDN $251,204.08 (2.38%), disability payments amounted to CDN $979,992.00 (9.32%), while lost wages due to disability payments measured a further CDN $2,801,433.60 (26.62% of total costs).


CONCLUSIONS
Over the period reviewed, ophthalmic costs rose by a factor 3.2 greater than that observed for goods and services captured by the Canadian Consumer Price Index. Further analyses over a longer follow-up period are required to definitively establish whether or not there is a long-term upward trend in ophthalmic costs.
Medical Economics & Epidemiology Unit, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107-5598, USA. afsmithweh@aol.com
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D000293:Adolescent; D001766:Blindness / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003930:Diabetic Retinopathy / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D017048:Health Care Costs / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D009674:Nova Scotia / Q000453:epidemiology; D009885:Ophthalmology / Q000191:economics* / Q000379:methods; D012189:Retrospective Studies