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dc.contributor.authorShickle, D.
dc.contributor.authorTodkill, D.
dc.contributor.authorChisholm, Catharine M.
dc.contributor.authorRughani, S.
dc.contributor.authorGriffin, M.
dc.contributor.authorCassels-Brown, A.
dc.contributor.authorMay, H.
dc.contributor.authorSlade, S.V.
dc.contributor.authorDavey, C.J.
dc.date.accessioned2020-03-12T13:01:16Z
dc.date.available2020-03-12T13:01:16Z
dc.date.issued2015
dc.identifier.citationShickle 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): 131-137en_US
dc.identifier.urihttp://hdl.handle.net/10454/17719
dc.description.abstractObjectives: 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.en_US
dc.description.sponsorshipYorkshire Eye Research, NHS Leeds and RNIBen_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.1016/j.puhe.2014.07.010en_US
dc.subjectEye disordersen_US
dc.subjectHealth servicesen_US
dc.subjectHealth economicsen_US
dc.subjectScreeningen_US
dc.subjectSensitivity analysisen_US
dc.subjectBarriersen_US
dc.subjectSocio-economically deprived communitiesen_US
dc.titleAddressing inequalities in eye health with subsidies and increased fees for General Ophthalmic Services in socio-economically deprived communities: A sensitivity analysisen_US
dc.status.refereedyesen_US
dc.typeArticleen_US
dc.type.versionNo full-text in the repositoryen_US


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