A telemedicine initiative has identified patients with diabetic retinopathy (DR) and other ocular pathologies in an underserved population that may have otherwise been missed, according to a study published in Clinical Ophthalmology. The screening program was cost-effective and has the societal benefit of administering to individuals within lower income communities.
Researchers conducted a retrospective chart review of 2251 patients between June 2014 and July 2016. A total of 35.1% (n=791), mean age 62 years, 36.2% Black, 43.7% Hispanic) followed up within a year of the original screening. The team identified DR in 519 patients, and 227 of those patients followed up for care within a year. The investigators determined that the screening program had a sensitivity of 77.2% and a specificity of 86.2% for detecting DR.
The team predicted revenue using standard Medicare rates and calculated societal benefit through quality adjusted life years (QALY). Overall, they recognized a revenue generation of $276,800, with a majority of it resulting from the treatment of retinal disease ($205,535). The researchers also calculated a societal benefit of 14.66 QALYs with an estimated value of $35,471/QALY.
“Given rapidly increasing rates of diabetes in the US and the substantial burden of diabetic eye disease, it has become increasingly imperative that we implement large scale diabetic retinopathy screening programs to adequately screen and treat patients who have poor access to healthcare,” according to the investigators. They also highlight the financial benefits stating, “our DR screening program was not only cost-effective but furthermore has the potential for significant profitability, particularly if follow-up visit compliance could be improved.”
Study limitations include its retrospective nature, single institution design, and the use of Medicare costs to estimate revenue instead of actual collections.
Muqri H, Shrivastava A, Muhtadi R, Chuck RS, Mian UK. The cost-effectiveness of a telemedicine screening program for diabetic retinopathy in New York City. ClinOphthalmol. Published online May 17, 2022. doi:10.2147/OPTH.S357766