Abstract:
PURPOSE:The aims of this study were: (i) to create a structural simulation model capable of predicting the future need and cost of eyecare services in Finland; and (ii) to test and rank different policy alternatives for access to care and the required physician workforce. METHODS:Using the system dynamics approach, the number and cost of patients with cataract, glaucoma, diabetic retinopathy and age-related macular degeneration (AMD) were described with causal-loop diagrams and were then translated into a set of mathematical equations to build a computer simulation model. Mathematically, the problem was formulated as a set of differential equations that were solved numerically with specialized software. The validity of the model was tested against prevalence and administrative historical data. The costs covered by the public sector in Finland were obtained from 2003 from the Finnish Hospital Discharge Register (including outpatient care), the Finnish Social Insurance Institution and a survey of hospital price lists. Different levels of access to public care were then simulated in four eye diseases, for which the model estimated the need for services and resources and their costs in the years 2005-2040. RESULTS:The model forecasted that the adoption of the 2005 national 'access to care' criteria for cataract surgery would shorten waiting lists. If the workload of Finnish ophthalmologists were kept at the 2003 level, the graduation rate of new ophthalmologists would have to increase by 75% from the current level. If all glaucoma patients were followed in the public sector in future, even this increase in training would not meet the demand for physician workforce. The current model indicated that the screening frequency of diabetes can be increased without large sacrifices in terms of costs. AMD therapy has a significant role in the allocation of future resources in eyecare. The modelling study predicted that ageing alone will increase the costs of eyecare during the next four decades in Finland by about 1% per year in real terms (undiscounted and without inflation of unit costs). The increases in total yearly costs were on average 8.6% between 2001 and 2003. CONCLUSIONS:The results of this modelling study indicate that policy initiatives, such as defining criteria for access to care, can have substantial implications on the demand for care and waiting times whereas the effect of ageing alone was relatively small. Measures to control several other factors - such as the adoption and price level of new technologies, treatments and practice patterns - will be at least equally important in order to restrain healthcare costs effectively.
journal_name
Acta Ophthalmoljournal_title
Acta ophthalmologicaauthors
Tuulonen A,Salminen H,Linna M,Perkola Mdoi
10.1111/j.1755-3768.2009.01532.xsubject
Has Abstractpub_date
2009-11-01 00:00:00pages
820-9issue
8eissn
1755-375Xissn
1755-3768pii
AOS1532journal_volume
87pub_type
杂志文章abstract:PURPOSE:To determine the molecular genetic cause in previously unreported probands with optic atrophy from the United Kingdom, Czech Republic and Canada. METHODS:OPA1 coding regions and flanking intronic sequences were screened by direct sequencing in 82 probands referred with a diagnosis of bilateral optic atrophy. D...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.13285
更新日期:2017-06-01 00:00:00
abstract:PURPOSE:To identify the causes of failure of the different surgical corneal graft techniques: penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK). METHODS:This multicentric retrosp...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.14708
更新日期:2021-01-09 00:00:00
abstract:PURPOSE:To indirectly measure stromal riboflavin penetration using commercially available riboflavin solutions and new and existing epithelium-off, trans-epithelial and iontophoresis-assisted delivery protocols. METHODS:Forty porcine eyes were divided into eight groups. Group 1: Ricrolin applied to the de-epithelialis...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.12884
更新日期:2016-03-01 00:00:00
abstract:PURPOSE:To investigate the incidence and cause of severe visual loss following use and removal of intraocular silicone oil (SiO) after uncomplicated vitrectomy and SiO injection for primary rhegmatogenous retinal detachment (RRD). METHODS:Consecutive case series of 216 patients operated with vitrectomy for primary RRD...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/j.1755-3768.2011.02248.x
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:To examine retinal vascular changes in the peripapillary and macular areas in patients with pituitary adenoma (PA) using optical coherence tomography angiography (OCTA). METHODS:Cross-sectional, retrospective study of 17 consecutive PA patients and 16 healthy subjects. All patients underwent a neuro-ophthalmol...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.14322
更新日期:2019-12-06 00:00:00
abstract:PURPOSE:To evaluate the biomechanical properties of the cornea using Corneal Visualization Scheimpflug Technology (CorVis ST, Oculus) in eyes with primary open-angle glaucoma (POAG) and normal control eyes. METHODS:A comparative cross-sectional study that included 42 patients with POAG and 60 normal control subjects m...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.12672
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:To investigate the intravitreal levels of potent vasoactive, angiogenic and extracellular matrix remodelling factors in the diabetic patients with simvastatin treatment. METHODS:This is an institutional, prospective, observational case-control study. Type-1 and type-2 diabetic patients on lipophilic simvastati...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.12363
更新日期:2014-11-01 00:00:00
abstract:PURPOSE:The clinical use and comparison of two recently developed A-scan ultrasound devices. METHODS:The same investigator determined central corneal thickness (CCT), anterior chamber depth (ACD) and axial length (AL) with an OcuScan RxP (Alcon, Forth Worth, Texas, USA) and an AL-2000 (Tomey, Erlangen, Germany) ultras...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/j.1600-0420.2007.00994.x
更新日期:2008-02-01 00:00:00
abstract:PURPOSE:To evaluate the diagnostic capacity of the Ocular Response Analyser's keratoconus match index (KMI) and keratoconus match probability (KMP) classification in a sample of keratoconus (KC) patients. METHODS:Keratoconus match index and KMP from 114 KC eyes, randomly selected from 114 patients with bilateral kerat...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.12056
更新日期:2013-06-01 00:00:00
abstract:PURPOSE:To investigate whether higher blood pressure and greater arterial stiffness are associated with the presence of macular cysts and whether this association is already present in the absence of micro-aneurysms in individuals with and without type 2 diabetes. METHODS:Using spectral domain optical coherence tomogr...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.14677
更新日期:2020-11-30 00:00:00
abstract:PURPOSE:To report the accuracy of intraocular lens (IOL) power estimation in eyes that have undergone phacovitrectomy for retinal diseases with accompanying macular oedema. METHODS:A retrospective study was conducted in 23 eyes of 23 patients at Soonchunhyang University Hospital, Seoul, Korea. The relationship between...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/j.1755-3768.2009.01752.x
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:To evaluate the positivity rate of temporal artery biopsies (TAB) performed in suspects of giant cell arteritis (GCA) and to study the epidemiological and clinical factors associated to the biopsy result. METHODS:A retrospective, multicenter, case-control study was performed, including three hundred and thirty...
journal_title:Acta ophthalmologica
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1755-3768.2012.02505.x
更新日期:2013-12-01 00:00:00
abstract:PURPOSE:To investigate the feasibility, effectiveness and acceptability of using prosthetic occluding contact lenses (OCLs) to treat moderate amblyopia in adults and of the role of the multifocal visual evoked potential (mfVEP) as a predictor of postamblyopic therapy. METHODS:A comparative, prospective, interventional...
journal_title:Acta ophthalmologica
pub_type: 杂志文章,随机对照试验
doi:10.1111/aos.13585
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:This paper reviews current knowledge about the pathogenesis, clinical manifestations and treatment of lattice corneal dystrophy, gelsolin type (LCD2, Meretoja's syndrome). METHODS:Material is derived from literature searches, a case study of a Finnish patient living in Sweden, and interviews in Helsinki with P...
journal_title:Acta ophthalmologica
pub_type: 杂志文章,评审
doi:10.1111/j.1755-3768.2009.01686.x
更新日期:2009-11-01 00:00:00
abstract:PURPOSE:Age-related macular degeneration (AMD) is generally considered a disease of the macula. However, recent studies show peripheral retinal lesions are prevalent in patients with AMD, indicative of a disease process that is more widespread. Full-field electroretinography (ffERG) measures an electrical response, not...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.14571
更新日期:2020-08-24 00:00:00
abstract:PURPOSE:To evaluate the efficacy and safety of intravitreal bevacizumab at one year follow-up, for the treatment of choroidal neovascularization (CNV) associated with angioid streaks. METHODS:A retrospective case series of eighteen eyes of 17 patients with CNV secondary to angioid streaks treated with intravitreal bev...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/j.1755-3768.2009.01836.x
更新日期:2011-11-01 00:00:00
abstract::Topically applied carbonic anhydrase inhibitors (CAIs) in eye drop solutions are commonly used to treat glaucoma. However, local eye irritation and multiple daily administrations may hamper their clinical usefulness. Aqueous eye drop formulations that improve their topical bioavailability and reduce their eye irritati...
journal_title:Acta ophthalmologica
pub_type: 杂志文章,评审
doi:10.1111/j.1755-3768.2011.02299.x
更新日期:2012-11-01 00:00:00
abstract:PURPOSE:To explore the clinical features, surgical interventions and prognosis of injured eyes following explosion and to develop the risk factors for poor prognosis. METHODS:A nested case-control study. To the date of 31 December 2018, 99 explosion-related eye globes were selected from the Eye Injury Vitrectomy Study...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.14713
更新日期:2021-01-08 00:00:00
abstract:PURPOSE:To establish whether differences in the assessment of diabetic macular oedema (DME) with either optical coherence tomography (OCT) or stereoscopic biomicroscopy lead to variability in the photocoagulation treatment of DME. METHODS:The differences in the assessment of DME with either OCT or stereoscopic biomicr...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/j.1755-3768.2012.02524.x
更新日期:2013-12-01 00:00:00
abstract:UNLABELLED:In this thesis the term eye amputation (EA) covers the removing of an eye by: evisceration, enucleation and exenteration. Amputation of an eye is most frequently the end-stage in a complicated disease, or the primary treatment in trauma and neoplasm. In 2010 the literature is extensive due to knowledge about...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/j.1755-3768.2010.02039.x
更新日期:2010-12-01 00:00:00
abstract:PURPOSE:Study the clinical and microbiological characteristics and the prognostic factors of post-traumatic endophthalmitis. METHODS:Seventeen eyes were included between 2004 and 2010, with clinical and microbiological data collected prospectively. Conventional cultures and panbacterial PCR were performed on aqueous a...
journal_title:Acta ophthalmologica
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1755-3768.2011.02349.x
更新日期:2013-08-01 00:00:00
abstract:PURPOSE:To test the validity of the eyesi surgical simulator as an assessment tool in a virtual reality vitreoretinal training programme. METHODS:In collaboration with an experienced vitreoretinal surgeon, a virtual vitreoretinal training programme was composed on the eyesi surgical simulator, software version 2.9.2 (...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.13209
更新日期:2017-02-01 00:00:00
abstract:PURPOSE:Complex segregation analysis of 60 unrelated sporadic keratoconus (KC) families was performed to reveal the presumed mode of inheritance in our dataset. METHODS:Sixty probands, 212 family members and 212 age and gender matched healthy controls underwent clinical and videokeratographic examination. Family aggre...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.12389
更新日期:2014-11-01 00:00:00
abstract:PURPOSE:To estimate the prevalence of primary angle-closure glaucoma (PACG), primary angle closure (PAC) and primary angle-closure suspect (PACS) and associated risk factors for PACG in a rural population in Northeast China. METHODS:A population-based survey was conducted in Bin County, Harbin, Northeast China. Glauco...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/j.1755-3768.2011.02146.x
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:To evaluate the trends and variations in global health burden of glaucoma by year, age and sex, region and socio-economic status, using disability-adjusted life years (DALYs). METHOD:The DALY numbers, crude DALY rate and age-standardized DALY rate globally and in each country were obtained the GBD 2015 study d...
journal_title:Acta ophthalmologica
pub_type: 杂志文章,多中心研究
doi:10.1111/aos.14044
更新日期:2019-05-01 00:00:00
abstract:PURPOSE:To investigate the reproducibility of Bruch's membrane opening minimum rim width (BMO-MRW) and retinal nerve fibre layer thickness (RNFLT) measurements using spectral domain optical coherence tomography (SD-OCT). Additionally, to investigate the reproducibility of BMO area measurements and fovea to BMO centre (...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.13464
更新日期:2017-11-01 00:00:00
abstract:PURPOSE:To investigate the amount of systemic oxidative stress-related DNA damage and serum total antioxidant status of patients with normal-tension glaucoma compared with healthy controls. METHODS:Forty-three patients with normal-tension glaucoma selected from 60 consecutive newly diagnosed patients with primary open...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/j.1755-3768.2010.01997.x
更新日期:2010-11-01 00:00:00
abstract:AIMS:This prospective, multicenter, single-masked study evaluated the additive effect of dorzolamide hydrochloride 2% on the diurnal intraocular pressure (IOP) curve and retinal and retrobulbar hemodynamics in patients with primary open-angle glaucoma (POAG) treated with morning-dosed bimatoprost 0.03%. METHODS:Eighty...
journal_title:Acta ophthalmologica
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/j.1755-3768.2010.02036.x
更新日期:2011-02-01 00:00:00
abstract:PURPOSE:To study the effect of glaucoma drainage implant (GDI) surgery on corneal topography during the first postoperative year. METHODS:Twenty-one adult glaucoma patients were implanted with a Molteno3 or a Baerveldt 250 GDI. Corneal topography measurements were taken preoperatively and at 6 and 12 months after surg...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/aos.14247
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND/AIMS:The mitotic count of uveal melanomas correlates with the risk of metastatic death, but with haematoxylin and eosin (H&E)-stained sections, it can be difficult to identify mitotic figures (MF) reliably. We investigated whether this measurement could be enhanced by immunohistochemistry, using the mitosis-...
journal_title:Acta ophthalmologica
pub_type: 杂志文章
doi:10.1111/j.1755-3768.2009.01769.x
更新日期:2011-03-01 00:00:00