Töteberg-Harms Marc, Berlin Michael S, Meier-Gibbons Frances
aDepartment of Ophthalmology, University Hospital Zurich, Zurich, Switzerland bGlaucoma Institute of Beverly Hills, West Hollywood cUniversity of California Los Angeles Stein Eye Institute, Los Angeles, California, USA dEye Center Rapperswil, Rapperswil, Switzerland.
Curr Opin Ophthalmol. 2017 Mar;28(2):127-132. doi: 10.1097/ICU.0000000000000343.
Despite a decrease in real average growth rates per capita since 2009, healthcare costs continue to rise worldwide. Numerous patient-related and doctor-related factors have contributed to this rise. Glaucoma is the leading cause of irreversible blindness and requires chronic, usually lifelong treatment. As with other chronic diseases, the adherence to prescribed treatment is often low and maybe influenced by the cost of the therapy. The purpose of this review is to seek potential solutions to best control the escalating costs of glaucoma care.
The studies we selected for this review can be divided into four different categories: costs of diagnostic tests; costs of direct comparisons between drugs or laser and conventional surgery; patient-related factors (such as adherence); and general aspects regarding costs: theoretical models and calculations.
It is challenging to find reliable studies concerning this subject matter. As patients are under the umbrellas of variously organized healthcare systems which span different cultures, the costs between countries are difficult to compare. However, one common aspect to lower costs in glaucoma care is to improve patient adherence. Theoretical models with actual patient studies could enable cost reductions by comparing multiple diagnostic and therapeutic scenarios. VIDEO ABSTRACT: http://links.lww.com/COOP/A22.
尽管自2009年以来人均实际平均增长率有所下降，但全球医疗保健成本仍在持续上升。众多与患者和医生相关的因素导致了这种增长。青光眼是不可逆性失明的主要原因，需要长期（通常是终身）治疗。与其他慢性病一样，患者对规定治疗的依从性往往较低，且可能受治疗费用的影响。本综述的目的是寻求潜在解决方案，以最佳控制不断攀升的青光眼治疗成本。
我们为本次综述所选的研究可分为四类：诊断检查成本；药物或激光与传统手术之间直接比较的成本；与患者相关的因素（如依从性）；以及成本的一般方面：理论模型和计算。
找到关于该主题的可靠研究具有挑战性。由于患者处于跨越不同文化的各种组织化医疗保健系统的覆盖之下，各国之间的成本难以比较。然而，降低青光眼治疗成本的一个共同方面是提高患者依从性。结合实际患者研究的理论模型通过比较多种诊断和治疗方案可实现成本降低。视频摘要：http://links.lww.com/COOP/A22
