Cost Analysis of a Comprehensive School Eye Screening Model from India

ABSTRACT

Purpose

School eye screening is a crucial strategy in the elimination of childhood blindness because of its ability to reach out to children who are otherwise inaccessible to eye care needs. Comprehensive screening programs are recommended and are beneficial, but the economic aspects of such models remain to be understood. This study aimed to analyse the cost of a comprehensive school eye screening model while utilizing optometrists and optometry students.

Methods

This cross-sectional study was conducted for 295 schools screened in the academic year 2018–2019. The analysis was performed from the service provider’s perspective including only the direct costs. Financial records were used for cost estimates. The outcome measures were cost per school and child, predictors for the cost, DALYs averted, cost of childhood blindness, and Benefit–Cost Ratio.

Results

A total of 65 094 children underwent screening from 295 schools. The median (IQR) cost per school and child for screening was $29.65 (29.65–44.34) and $0.66 (0.32–1.13). The regression model predicted that the cost of screening was dependent on school strength, number of screening personnel, distance of the schools, and deliverables. With the interventions to improve compliance, 14686.30 DALYs have been averted. Loss of productivity due to childhood blindness was estimated to be $339070.83. Screening for colour vision also had a Benefit–Cost ratio of greater than one.

Conclusion

Cost of screening was low and the benefits were high while utilising optometrist and optometry students along with a comprehensive screening protocol.

KEYWORDS:

• cost-effectiveness
• school eye screening
• optometrists
• cost per child
• comprehensive

Acknowledgments

The authors acknowledge the Qatar Fund for Development for the financial support and Orbis for the technical support in the implementation of the REACH program of which this was a part.

Disclosure statement

None of the authors have any proprietary or conflicts of interest related to this submission.

This submission has not been published anywhere previously, and it is not simultaneously being considered for any other publication.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.