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

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    Publication date
    2015
    Author
    Shickle, D.
    Todkill, D.
    Chisholm, Catharine M.
    Rughani, S.
    Griffin, M.
    Cassels-Brown, A.
    May, H.
    Slade, S.V.
    Davey, Christopher J.
    Keyword
    Eye disorders
    Health services
    Health economics
    Screening
    Sensitivity analysis
    Barriers
    Socio-economically deprived communities
    Peer-Reviewed
    yes
    
    Metadata
    Show full item record
    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. Conclusions: In order to support the financial viability of primary eye care in socio-economically deprived communities, income is required from additional subsidies or from sources other than eye examinations, such as ophthalmic or other optometric community services. This would require a significant shift of activity from secondary to primary care locations. The subsidy required could also be justified by the utility gain from earlier detection of preventable sight loss.
    URI
    http://hdl.handle.net/10454/17719
    Version
    No full-text in the repository
    Citation
    Shickle D, Todkill D, Chisholm C et al (2015) Addressing inequalities in eye health with subsidies and increased fees for General Ophthalmic Services in socio-economically deprived communities: A sensitivity analysis. Public Health, 129(2): 131-137
    Link to publisher’s version
    https://doi.org/10.1016/j.puhe.2014.07.010
    Type
    Article
    Collections
    Life Sciences Publications

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