Coast J, Spencer I C, Smith L, Spry P G
Department of Social Medicine, University of Bristol, UK.
J Health Serv Res Policy. 1997 Jan;2(1):19-25. doi: 10.1177/135581969700200106.
To compare the costs of monitoring stable glaucoma patients by community optometrists and hospital ophthalmologists.
A cost analysis was conducted alongside a randomised controlled trial which compared the accuracy and acceptability of measurement in each form of care. The viewpoints of the health service and of patients were considered. Costs were assessed using a number of different methods. Sensitivity analysis was conducted for key variables.
The baseline analysis reflected heavily the different length of time between follow-up in the two arms of the trial (10 months (average) for hospital, 6 months for optometrists). It showed annual cost per patient for hospital ophthalmologists varied from 14.50 pounds to 59.95 pounds, and community optometrist costs varied from 68.98 pounds to 108.98 pounds. Assuming a 6-month follow-up interval for the hospital ophthalmologists, costs varied from 24.16 pounds to 99.92 pounds.
Recommendations about the least costly form of follow-up must depend on the context in which the decision is being taken and the scale of change envisaged. If the aim is to recoup resources from hospitals in order to pay for monitoring in the community, community monitoring is unlikely to be the least costly option.
比较社区验光师和医院眼科医生监测稳定期青光眼患者的成本。
在一项随机对照试验的同时进行成本分析，该试验比较了每种护理形式下测量的准确性和可接受性。考虑了卫生服务机构和患者的观点。使用多种不同方法评估成本。对关键变量进行了敏感性分析。
基线分析很大程度上反映了试验两组随访时间的差异（医院平均为10个月，验光师为6个月）。结果显示，医院眼科医生每名患者的年度成本从14.50英镑到59.95英镑不等，社区验光师的成本从68.98英镑到108.98英镑不等。假设医院眼科医生的随访间隔为6个月，成本从24.16英镑到99.92英镑不等。
关于成本最低的随访形式的建议必须取决于做出决策的背景以及设想的变化规模。如果目标是从医院收回资源以支付社区监测费用，社区监测不太可能是成本最低的选择。
