Cheaper Can Be Better: Cutting Costs and Improving Low Vision Aid Service

Abstract

The traditional Low Vision Aid service using Hospital Eye Service Prescription forms is expensive and often associated with poor patient satisfaction as found in the studies by Mcllwaine, Bell and Dutton (1991) and by Humphrey and Thompson (1986). We audited this service in a district general hospital. Subsequently a more integrated "In House" Low Vision Aid clinic was established. The new service was re-audited to compare costs and also to look at patient satisfaction. The first audit composed a retrospective analysis of over two years of Hospital Eye Service Prescription forms (495 forms) which were traced through the optometrists/opticians and the Health Authority's finance department. In the second audit a retrospective analysis, of the records of 102 patients and a telephone survey were undertaken. In the first audit the average cost per patient receiving Low Vision Aids was £107.43; in the second this figure was £47.83 suggesting the integrated Low Vision Aid clinic is more cost-effective. We also obtained a patient satisfaction rate of 76%.

What is the cost of blindness?

“…18 The low vision aid cost was an assessment of hospital eye service prescription forms in a district general hospital. 19 Expert opinion has been used to estimate the proportion using low vision aids. 20 21 The cost of low vision rehabilitation is from a cost per care episode of a health authority community occupational therapist.…”

“…14 The low cost of low vision aids is from an audit of an ''in-house'' NHS hospital low vision aid service. 19 This was not taken as the standard cost as a recent survey has shown that only 32% of low vision aid services are of this type. 34 For the percentages of low vision aid provision, the estimate by Margrain is the more recent 21 but the RNIB report may be more accurate.…”

Models of low vision care: past, present and future

“…In the early 1990s, when reports on the effectiveness of optometric low vision services in the UK were not encouraging, the services in Scandinavia were reporting improved effectiveness by incorporating a low vision therapist . This influenced some UK services to swap to a low vision therapy model of provision that incorporated a specially‐trained ‘low vision therapist’ …”

“…15,16 This influenced some UK services to swap to a low vision therapy model of provision that incorporated a specially-trained 'low vision therapist'. 17,18 A study in the UK 19 failed to measure any improvements in outcomes, when a 'low vision therapist' was incorporated into a service but another randomised controlled trial is now under way in America. 20…”