Cost Savings Analysis for a Diabetic Retinopathy Teleretinal Screening Program Using an Activity-Based Costing Approach

Robert B Garoon; Weijie V Lin; Alex K Young; Allison G Yeh; Yvonne I Chu; Christina Y Weng

doi:10.1016/j.oret.2018.01.020

Cost Savings Analysis for a Diabetic Retinopathy Teleretinal Screening Program Using an Activity-Based Costing Approach

Ophthalmol Retina. 2018 Sep;2(9):906-913. doi: 10.1016/j.oret.2018.01.020. Epub 2018 Mar 9.

Authors

Robert B Garoon¹, Weijie V Lin², Alex K Young¹, Allison G Yeh², Yvonne I Chu¹, Christina Y Weng³

Affiliations

¹ Department of Ophthalmology, Baylor College of Medicine, Houston, Texas; Department of Ophthalmology, Ben Taub General Hospital, Harris Health System, Houston, Texas.
² School of Medicine, Baylor College of Medicine, Houston, Texas.
³ Department of Ophthalmology, Baylor College of Medicine, Houston, Texas; Department of Ophthalmology, Ben Taub General Hospital, Harris Health System, Houston, Texas. Electronic address: christina.weng@bcm.edu.

PMID: 31047224
DOI: 10.1016/j.oret.2018.01.020

Abstract

Purpose: To examine the costs and cost savings associated with a large, urban teleretinal screening program for diabetic retinopathy (DR).

Design: Retrospective analysis.

Participants: Eighteen thousand twenty-five patients (36 050 eyes) screened via the Harris Health System (HHS) DR teleretinal screening program between June 2013 and April 2014.

Methods: Activity-based costing applied to the operational screening pathway was implemented to determine the cost of screening. Actual costs were calculated based on retrospective chart review and figures obtained from the HHS and Centers for Medicare and Medicaid Services. Theoretical costs of in-clinic examinations and delayed intervention were compared with actual costs of screening and treatment to determine costs savings.

Main outcome measures: Costs and cost savings in United States dollars were estimated.

Results: The per-patient cost of teleretinal screening itself was found to be $27.35, whereas the average total cost (factoring in treatment) per patient was determined to be $43.14. The physical examination-only and treatment-only models yielded cost savings estimates of $2 047 442.53 and $1 148 597.35, respectively.

Conclusions: The cost savings yielded by the HHS DR teleretinal screening program compared with conventional screening are substantial and corroborate the findings of similar studies that have analyzed teleretinal screening. Additionally, it can be presumed that there are additional indirect economic benefits resulting from earlier detection and treatment of disease.