TY - JOUR
T1 - Economic cost of cataract surgery procedures in an established eye care centre in Southern India
AU - Muralikrishnan, R.
AU - Venkatesh, R.
AU - Venkatesh Prajna, N.
AU - Frick, Kevin D.
N1 - Funding Information:
This study was supported in part by CBM International, Germany through a scholarship grant for the corresponding author at the London School of Hygiene and Tropical Medicine, London. The authors would like to deeply acknowledge Prof.Charles Normand, Damian Walker and Dr. Allen Foster (London School of Hygiene and Tropical Medicine), Dr.Elliot Marseille (Health Strategies International), Dr. G. Natchiar and Mr.R.D. Thulasiraj (Aravind Eye Care System) for their appropriate guidance and comments.
PY - 2004/12
Y1 - 2004/12
N2 - PURPOSE: To estimate the direct and indirect costs of three cataract surgery procedures: extracapsular cataract extraction with intraocular lens implantation (ECCE-IOL), phacoemulsification (PHACO) and manual small incision cataract surgery (MSICS) using economic costing principles in a well-established eye care programme (Aravind Eye Hospital) in Tamil Nadu, South India during 2000-01. Previous literature suggests that PHACO and MSICS have similar effectiveness. METHODS: The average unit cost for each surgical procedure was calculated from the societal perspective using economic costing methods. Total annual provider's direct costs for each input to surgery were calculated and apportioned appropriately to different cataract surgery techniques using a 'micro-costing approach. The patient's direct and indirect costs for each procedure were calculated by interviewing staff and patients and by using assumptions about prices for relevant cost items such as transportation, food, medicine, spectacles and economic productivity loss. RESULTS: Average provider's direct costs were highest for PHACO procedures (US $25.55) compared to MSICS ($17.03) and ECCE-IOL ($ 16.25). Tb e difference can be attributed to the cost of equipment and materials. Average direct and indirect patient costs were highest for ECCE-IOL ($19.85), while the costs for PHACO and MSICS were identical ($12.37). ECCE-IOL had the highest total costs and MSICS had the lowest total costs from the societal perspective. CONCLUSIONS: Our results suggest that MSICS may have a lower societal cost than other options. Government and NGO hospitals providing cataract surgeries should invest in regular cost analyses, reviews of the literature on effectiveness, and formal cost-effectiveness analyses in order to plan economically efficient interventions. Considering the small incremental cost for providers (less than US$1), improved outcomes, and lower patient costs, we also believe that MSICS is an important technique to use in efforts to eliminate cataract blindness in India and this result may be generalised to other developing countries.
AB - PURPOSE: To estimate the direct and indirect costs of three cataract surgery procedures: extracapsular cataract extraction with intraocular lens implantation (ECCE-IOL), phacoemulsification (PHACO) and manual small incision cataract surgery (MSICS) using economic costing principles in a well-established eye care programme (Aravind Eye Hospital) in Tamil Nadu, South India during 2000-01. Previous literature suggests that PHACO and MSICS have similar effectiveness. METHODS: The average unit cost for each surgical procedure was calculated from the societal perspective using economic costing methods. Total annual provider's direct costs for each input to surgery were calculated and apportioned appropriately to different cataract surgery techniques using a 'micro-costing approach. The patient's direct and indirect costs for each procedure were calculated by interviewing staff and patients and by using assumptions about prices for relevant cost items such as transportation, food, medicine, spectacles and economic productivity loss. RESULTS: Average provider's direct costs were highest for PHACO procedures (US $25.55) compared to MSICS ($17.03) and ECCE-IOL ($ 16.25). Tb e difference can be attributed to the cost of equipment and materials. Average direct and indirect patient costs were highest for ECCE-IOL ($19.85), while the costs for PHACO and MSICS were identical ($12.37). ECCE-IOL had the highest total costs and MSICS had the lowest total costs from the societal perspective. CONCLUSIONS: Our results suggest that MSICS may have a lower societal cost than other options. Government and NGO hospitals providing cataract surgeries should invest in regular cost analyses, reviews of the literature on effectiveness, and formal cost-effectiveness analyses in order to plan economically efficient interventions. Considering the small incremental cost for providers (less than US$1), improved outcomes, and lower patient costs, we also believe that MSICS is an important technique to use in efforts to eliminate cataract blindness in India and this result may be generalised to other developing countries.
KW - Cataract extraction
KW - Extracapsular cataract extraction
KW - Eye care cost
KW - India
KW - Manual small incision cataract surgery
KW - PHACO emulsification
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U2 - 10.1080/09286580490888762
DO - 10.1080/09286580490888762
M3 - Review article
C2 - 15590584
AN - SCOPUS:11844268628
SN - 0928-6586
VL - 11
SP - 369
EP - 380
JO - Ophthalmic Epidemiology
JF - Ophthalmic Epidemiology
IS - 5
ER -