Addressing inequalities in eye health with subsidies and increased fees for General Ophthalmic Services in socio-economically deprived communities: A sensitivity analysis

Darren Shickle, Daniel Todkill, Catharine Chisholm, Sonal Rughani, Marcus Griffin, Andy Cassels-Brown, Helen May, Sarah V. Slade, Christopher J. Davey

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Objectives: Poor knowledge of eye health, concerns about the cost of spectacles, mistrust of optometrists and limited geographical access in socio-economically deprived areas are barriers to accessing regular eye examinations and result in low uptake and subsequent late presentation to ophthalmology clinics. Personal Medical Services (PMS) were introduced in the late 1990s to provide locally negotiated solutions to problems associated with inequalities in access to primary care. An equivalent approach to delivery of optometric services could address inequalities in the uptake of eye examinations. Study design: One-way and multiway sensitivity analyses. Methods: Variations in assumptions were included in the models for equipment and accommodation costs, uptake and length of appointments. The sensitivity analyses thresholds were cost-per-person tested below the GOS1 fee paid by the NHS and achieving break-even between income and expenditure, assuming no cross-subsidy from profits from sales of optical appliances. Results: Cost per test ranged from £24.01 to £64.80 and subsidy required varied from £14,490 to £108,046. Unused capacity utilised for local enhanced service schemes such as glaucoma referral refinement reduced the subsidy needed.

Original languageEnglish
Pages (from-to)131-137
Number of pages7
JournalPublic Health
Volume129
Issue number2
DOIs
Publication statusPublished - 1 Feb 2015
Externally publishedYes

Keywords

  • Eye disorders
  • Health economics
  • Health services
  • Screening
  • Sensitivity analysis

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