title: Cost-utility analysis of rhegmatogenous retinal detachment surgery in Shanghai, China.
abstract: OBJECTIVE
  To perform a short-term and a long-term cost-utility analysis of rhegmatogenous retinal detachment (RRD) surgery in Shanghai, China.
  
  
  METHODS
  A total of 117 patients who underwent RRD surgery at Shanghai First People's Hospital, Affiliated Shanghai Jiaotong University, and then underwent follow-up for at least 1 year, were included in the study. Costs associated with RRD surgery and time trade-off utility values before and after surgery were recorded. Short-term analysis was made for 1 year. Quality-adjusted life years (QALYs) gained by RRD surgery over the lifetime were calculated at a 3% discount rate in the long-term analysis. This study used the bootstrap method in statistical analysis and one-way sensitivity analyses to test robustness of the results.
  
  
  RESULTS
  Compared with no treatment, the mean incremental costs of RRD surgery was 11,384 Chinese yuan (CN¥) (US$1751); the mean additional QALYs gained was 0.05 (95% confidence interval [CI] 0.04-0.06) for 1 year and 0.88 (95% CI 0.64-1.13) for life expectancy; the incremental cost effectiveness ratio (ICER) was CN¥224,921 (US$34,603)/QALY for the short-term, and CN¥13,794 (US$2122)/QALY for the long-term. In short-term analysis, the ICER was CN¥150,087 (US$23,090)/QALY for scleral buckling surgery, and CN¥507,727 (US$78,112)/QALY for vitreous surgery. In the long-term analysis, the ICER was CN¥6280 (US$966)/QALY for scleral buckling, and CN¥30,756 (US$4732)/QALY for vitreous surgery.
  
  
  CONCLUSIONS
  For RRD patients, surgery increases QALYs. In a 1-year analysis, surgery is not a cost-effective treatment, however it is cost-effective over the lifetime.
authors: Department of Ophthalmology, Shanghai First People's Hospital, Affiliated Shanghai Jiaotong University , Shanghai , China .
authors: Yingyan
authors: Y
authors: Ma
authors: Xiaohua
authors: X
authors: Ying
authors: Haidong
authors: H
authors: Zou
authors: Xiaocheng
authors: X
authors: Xu
authors: Haiyun
authors: H
authors: Liu
authors: Lin
authors: L
authors: Bai
authors: Xun
authors: X
authors: Xu
authors: Xi
authors: X
authors: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D019057:Quality-Adjusted Life Years; D012163:Retinal Detachment / Q000191:economics* / Q000523:psychology / Q000601:surgery*; D012591:Scleral Buckling / Q000191:economics*; D018434:Sickness Impact Profile; D014821:Vitrectomy / Q000191:economics*
keywords: Cost-utility analysis; incremental cost-effectiveness ratio; quality-adjusted life years; retinal detachment; time trade-off