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Glaucoma in the United States and europe: predicting costs and surgical rates based upon stage of disease.

Abstract：

PURPOSE:Primary open-angle glaucoma is a significant health-economic burden in both the United States and Europe that is likely to increase. This study compared treatment patterns and cost among patients with primary open-angle glaucoma in these locations. METHODS:Retrospective medical chart reviews were conducted in the United States (1990 to 2002) and Europe (1995 to 2003). A total sample of 151 US charts and 194 European charts was studied, and patients were assigned a baseline intraocular pressure (IOP) and baseline stage, using a 6-stage visual functional glaucoma staging algorithm. Resource utilization and direct costs were assessed by stage of disease using publicly available United States and European costs. Cox Proportional Hazards modeling were used to examine covariates predicting glaucoma surgery. Total cost was predicted, adjusting for covariates using Generalized Linear Models, with baseline stage as the independent variable. RESULTS:Glaucoma surgery requirement was highly associated with baseline disease stage and IOP increase before surgery in the United States and somewhat associated with these factors in Europe. Within both locations, baseline IOP was highly associated with glaucoma surgery requirement. Controlling for covariates, patients at higher baseline stages incurred greater costs in the United States (P=0.0017) and Europe (P=0.0715). Surgery and medication were also highly predictive of increased cost (P<0.0001). Cost of care differed greatly between the European countries, with costs lowest in Italy. CONCLUSIONS:Increases in annual cost were related to higher baseline IOP, higher baseline stage, medication, and surgery. Thus, significant potential savings and reductions in annual healthcare burden are possible if patients are diagnosed and treated at earlier stages of glaucoma.

journal_name

J Glaucoma

journal_title

Journal of glaucoma

authors

Lee PP,Kelly SP,Mills RP,Traverso CE,Walt JG,Doyle JJ,Katz LM,Siegartel LR,Costs of Glaucoma Study Group.

doi

10.1097/IJG.0b013e3180575202

subject

Has Abstract

pub_date

2007-08-01 00:00:00

pages

471-8

issue

eissn

1057-0829

issn

1536-481X

pii

00061198-200708000-00008

journal_volume

pub_type

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Glaucoma in the United States and europe: predicting costs and surgical rates based upon stage of disease.