Implementing an optometrist-assisted and teleophthalmology-enabled referral pathway (OTRP) in community optometry could revolutionize eye care delivery systems. By utilizing risk stratification, OTRP aims to enhance efficiency and reduce unnecessary referrals. This study evaluates the future costs and benefits of various organizational set-ups for OTRP in Denmark, offering critical insights into its potential impact on healthcare.
A decision-analytic model with a one-year time horizon was constructed to compare different patient referral pathways for suspected ocular posterior segment eye disease. The primary measures assessed were overall healthcare costs per patient, average waiting times from initial examination to treatment or referral completion, and quality-adjusted life-years (QALY) gained. The study contrasted the general ophthalmologist referral pathway (GO-RP) with potential reimbursement (R-OTRP) and procurement (P-OTRP) models for OTRP.
Cost Efficiency
The study revealed significant cost savings with OTRP models. The cost per patient for GO-RP was estimated at £116, whereas P-OTRP and R-OTRP were £75 and £94 respectively. This substantial reduction in costs underscores the financial viability of the OTRP approach, making it a compelling alternative to traditional referral pathways.
Waiting Time and Quality of Life
Waiting times for diagnosis or referral completion showed marked improvement with OTRP. GO-RP patients experienced an average wait of 25 weeks, while P-OTRP and R-OTRP reduced this to approximately 5.7 weeks. Moreover, QALY gains were higher for OTRP models (0.15) compared to GO-RP (0.06), indicating enhanced quality of life for patients.
Key Takeaways
• OTRP models significantly reduce healthcare costs per patient compared to GO-RP.
• Patients in OTRP pathways experience substantially shorter waiting times.
• Quality of life, measured in QALY gains, is notably higher with OTRP models.
• Implementing OTRP could streamline the referral process, improving overall efficiency and patient outcomes.
The findings suggest that adopting OTRP in the Danish eye care system could enhance efficiency, lower costs, and improve patient quality of life. Future healthcare policies should consider these benefits when designing referral pathways for ocular diseases.
Original Article: Eye (Lond). 2024 Jun 4. doi: 10.1038/s41433-024-03156-4. Online ahead of print.
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