Ambulatory and hospital care of glaucoma in Spain and associated medical costs

Abstract

Objectives

This study aimed to analyze the impact of glaucoma in ambulatory centers and hospitals in Spain over the past decade, in terms of incidence and medical costs.

Methods

Administrative data of glaucoma patients from ambulatory centers and hospitals in Spain and registered between 2011 and 2020 was obtained from a Spanish National discharge database. Medical costs obtained were based on the diagnosis-related group-based hospital payment systems, determined by the Spanish Ministry of Health.

Results

Data from 100,734 ambulatory care visits and 11,408 hospital admissions related to glaucoma were obtained from the database. Most of the cases were registered in patients over 65 years of age. The incidence of glaucoma in ambulatory centers was 2.2 per 10,000 persons over the study period; in hospitals, the incidence was 0.2 per 10,000 persons. The incidence of glaucoma in ambulatory settings increased significantly over the study period, while the incidence in hospitals decreased over the same period. Most ambulatory visits and hospital admissions were programmed or non-urgent. The mean cost per ambulatory visit was €954, €5.5 million in total annually; the mean cost per hospital admission was €3,727, €4.1 million in total annually. The annual cost of ambulatory care increased significantly over the study period, while the annual cost of hospital care decreased significantly.

Conclusions

The medical costs of glaucoma in Spanish hospitals decreased over the study period, while the costs of ambulatory care increased. This shift in the management of glaucoma should be considered in future resource allocation decisions.

Keywords:

• Glaucoma
• ambulatory care
• hospital care
• medical cost
• Spain

JEL codes:

• H51
• H5
• H
• I10
• I1
• I

Transparency

Declaration of funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Declaration of financial and other interest

The authors declare that they have no competing interests.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

JD contributed to the investigation by analyzing and interpreting the burden associated to glaucoma in Spain and was a major contribution in the intellectual content revision. AM analyzed the current situation of glaucoma in Spain, interpreted the statistical data and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.

Data availability statement

Data sharing is restricted due to legal stipulations, yet the data that support the findings of this study is fully available from the Spanish Ministry of Health via the Unit of Health Care Information and Statistics (Spanish Institute of Health Information) for researchers who meet the criteria for access to confidential data at: https://www.mscbs.gob.es/estadEstudios/sanidadDatos/home.htm.

Ethics approval and consent to participate

Ethics committee approval and consent were not required for this study.