Screening for Diabetic Retinopathy: Cost-Effectiveness Analysis of Direct Eye Examination versus Telescreening in Rio Grande Valley, Texas Open Access
Aseem, Fazila (2013)
Diabetic retinopathy poses a significant health concern in underserved and isolated, Hispanic-populated Rio Grande Valley, Texas. Hispanics have greater risk of contracting diabetic retinopathy compared to other races due to many reasons, including socioeconomics and behavioral risk factors. Diabetes is also significantly prevalent in Rio Grande Valley, increasing the risk of developing diabetic retinopathy among the target population.
Screening provides an effective way to reduce the burden of the disease. There are alternative methods of screenings for diabetic retinopathy: direct eye examination and retinal photography followed by necessary eye care and/or both, with tradeoffs to consider. Therefore, cost, access and quality concerns associated with different screening alternatives ought to be considered before implementing a strategy at population-level.
Rio Grande Valley's residents are dispersed and lack compliance to seek follow-up care. With higher prevalence, little access to preventive care, and greater cultural and economic barriers, finding cost-effective ways of reaching and screening diabetes patients in these Hispanic-populated regions is critical. By conducting a literature search and running a cost-effectiveness analysis of telescreening in primary care settings vs. direct eye examination by retina specialists, this study provides an economical model to enhance access to and quality of screening diabetes patients for diabetic retinopathy in Rio Grande Valley, Texas.
Table of Contents
Table of ContentsChapter 1: Introduction
1.1 Introduction and Rational1.2 Problem Statement
1.3 Theoretical Framework1.4 Purpose Statement
1.5 Significance Statement
1.6 Terms and Abbreviations
Chapter 2: Review of the Literature2.1 Introduction 2.2 Literature Review
2.3 Summary of Current Problem and Study RelevanceChapter 3: Methodology 3.1 Introduction 3.2 Population and Sample 3.3 Research Study Design 3.4 Procedures 3.5 Data Analysis Plan 3.6 Limitations and Delimitations Chapter 4: Results 4.1 Introduction 4.2 Findings Summary
Chapter 5: Conclusions, Implications and Recommendations
5.1 Introduction5.2 Summary of Study 5.3 Conclusions 5.4 Implications 5.5 Recommendations References
Appendix S1: Search terms and strategies
Appendix S2: A simplified yearlong decision scenario for diabetic retinopathy screening
List of tables and figures
Figure 2.1: Flow of study selection
Figure 4.1: Estimated prevalence of diabetic retinopathy in Rio Grande Valley, Texas
Table 2.1: Inclusion criteria for data sources
Table 2.2: Inclusion criteria for study models
Table 2.3: Summary of health screening studies for diabetic retinopathy
Table 2.4: Economic analysis of telescreening for diabetic retinopathy
Table 3.1: Intervention activities during eye exams and telescreeningTable 3.2: Tangible direct medical costs Table 3.3: Tangible direct non-medical costs
Table 4.1: Approximate intermediate and final outcome measures
Table 4.2: Cost of outcomes
Table 4.3: Decision tree cost calculations
Table 4.4: Cost, access and outcome data .
Table 4.5: ICER summary
About this Master's Thesis
|Committee Chair / Thesis Advisor|
|Screening for Diabetic Retinopathy: Cost-Effectiveness Analysis of Direct Eye Examination versus Telescreening in Rio Grande Valley, Texas ()||2018-08-28 12:30:11 -0400||