RT info:eu-repo/semantics/article
T1 Cost-effectiveness of a telemedicine optometric-based assessment for screening diabetic retinopathy in a country with a universal public health system
A1 Ortiz Toquero, Sara
A1 Aleixandre Mendizábal, Guillermo
A1 Valpuesta, Yolanda
A1 Pérez Fernández, Cristina
A1 De la Iglesia, Purificación
A1 Pastor Jimeno, José Carlos
A1 López Gálvez, María Isabel
K1 Optometría
K1 Oftalmología
K1 Coste eficacia
K1 Retinopatía diabética
K1 Centro de lectura
K1 Optometría
K1 Telemedicina
K1 2209.15 Optometría
K1 3201.09 Oftalmología
AB Objective: To determine the cost-effectiveness of a new telemedicine optometric-based screening program of diabetic retinopathy (DR) compared with traditional models' assessments in a universal European public health system. Methods: A new teleophthalmology program for DR based on the assessment of retinographies (3-field Joslin Vision Network by a certified optometrist and a reading center [IOBA-RC]) was designed. This program was first conducted in a rural area 40 km from the referral hospital (Medina de Rioseco, Valladolid, Spain). The cost-effectiveness was compared with telemedicine based on evaluations by primary care physicians and general ophthalmologists, and to face-to-face examinations conducted by ophthalmologists. A decision tree model was developed to simulate the cost-effectiveness of both models, considering public and private costs. The effectiveness was measured in terms of quality of life. Results: A total of 261 patients with type 2 diabetes were included (42 had significant DR and required specific surveillance by the RC; 219 were undiagnosed). The sensitivity and specificity of the detection of DR were 100% and 74.1%, respectively. The telemedicine-based DR optometric screening model demonstrated similar utility to models based on physicians and general ophthalmologists and traditional face-to-face evaluations (0.845) at a lower cost/patient (€51.23, €71.65, and €86.46, respectively). Conclusions: The telemedicine-based optometric screening program for DR in a RC demonstrated cost savings even in a developed country with a universal health care system. These results support the expansion of this kind of teleophthalmology program not only for screening but also for the follow-up of diabetic patients.
PB Mary Ann Libert, INC
SN 1530-5627
YR 2024
FD 2024
LK https://uvadoc.uva.es/handle/10324/79394
UL https://uvadoc.uva.es/handle/10324/79394
LA eng
NO Telemed J E Health. 2024 Dec;30(12):2824-2833.
DS UVaDOC
RD 07-nov-2025