Vernacchio Louis, Trudell Emily K, McLaughlin Sarah R, Bhambhani Vijeta
1 Pediatric Physicians' Organization at Children's, Brookline, MA, USA.
2 Boston Children's Hospital, Boston, MA, USA.
Clin Pediatr (Phila). 2019 May;58(5):541-546. doi: 10.1177/0009922819832020. Epub 2019 Feb 19.
Recently, several professional groups have recommended a change from chart-based to instrument-based screening for preschool-age children, but the effect of this change on health care utilization is unknown. We performed a secondary analysis of a site-randomized quality improvement project on transitioning from chart-based to instrument-based vision screening for 3- to 5-year-old children in primary care. We analyzed visit rates to ophthalmologists and optometrists and costs of such care before and after implementation of instrument-based vision screening with comparison to nonparticipating practices. The implementation of instrument-based vision screening resulted in a decrease in visits to eye care specialists from 83.1 visits per 1000 children per year to 55.0, a reduction of 33.8%; no comparable reduction was seen in nonparticipating practices. The cost of services by eye care specialists fell from $65 715 per 1000 children per year prior to $55 740, a decline of 15.2%; similar costs among control practices rose 13.4%.
