Provision and cost of children's and young people's eye services in the UK: findings from a single primary care trust

Alexander, Philip; Rahi, Jugnoo S; Hingorani, Melanie

doi:10.1136/bjo.2008.149203

Cited by 8 publications

(5 citation statements)

References 25 publications

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“…The share of inpatient care expenditure relative to total health-care expenditure among children with difficulty in vision was not as high as that among children with disabilities in other domains. This low share of inpatient care is consistent with the fact that among the pediatric population in the UK, the proportion of children who received hospital eye services and required hospital admission was low (less than 10%) and with the fact that the total cost of ophthalmic surgery and inpatient eye services was less than that of ophthalmology outpatient eye services 15 ) .…”

Section: Discussionsupporting

confidence: 71%

Out-of-pocket Costs of Disabilities and Their Association with Household Socioeconomic Status Among School-aged Children in Vietnam

et al. 2013

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Objective: The aim of this study was to assess the economic burden of disability of school-aged children and to evaluate the association between disabilities and household socioeconomic status, as well as the economic burden of disability and household socioeconomic status in Vietnam.Materials and Methods: Nationally representative data for 9,882 children aged 6 to 17 years from the Vietnam Household Living Standard Survey 2006 were used. Disabilities were measured in six basic functional domains, including vision, hearing, remembering or concentrating, mobility, self-care, and communication. We evaluated the association between area, household income, educational attainment, or occupation of household head, and each difficulty. The ratio of health-care expenditure to per capita household income was compared by presence of a disability as well as household socioeconomic status.Results: The prevalence of difficulty was 1.9% for vision and 2.3% for at least one of the other five domains. Difficulty in vision was more prevalent in the richer households (p=0.001), whereas difficulty in the other five domains was more prevalent in the poorer households (p=0.002). The ratio of health-care expenditure to per capita household income was greater than 0.05 in 4.6% of children. The adjusted odds ratio of children with difficulty in vision having a health-care expenditure share greater than 0.05 compared with children without difficulty was 4.78 (95% CI: 2.95, 7.73; p<0.001), and that for difficulty in the other five domains was 3.13 (95% CI: 2.04, 4.80; p<0.001). Among children with difficulty in at least one of the five domains other than vision, the proportion of children with a health-care expenditure share greater than 0.05 was higher among children from the poorer households (p=0.033).Conclusions: Children with a disability spent more on health care relative to their income than those without. Visual disability was more prevalent among children from the richer households, whereas other disabilities were more prevalent among children from the poorer households.

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Section: Discussionsupporting

confidence: 71%

Out-of-pocket Costs of Disabilities and Their Association with Household Socioeconomic Status Among School-aged Children in Vietnam

et al. 2013

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“…A review of the published literature was carried out to explore current challenges in vision services for children and uptake of referrals and treatments. However, most of the literature reported findings from non-UK settings, and the few publications related to childhood vision care in the UK did not explore barriers to service uptake and treatment compliance ( Alexander et al 2009 ; Little & Saunders 2015 ; Bruce & Outhwaite 2013 ; Solebo et al 2013 ; Solebo et al 2015 ; Toufeeq & Oram 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Challenges of Eye Health Care in Children and Strategies to Improve Treatment Uptake: A Qualitative Study from the Perspective of Eye Care Professionals in the UK

Cassetti

Sanders

Bruce³

2019

British and Irish Orthoptic Journal

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Follow up from universal vision screening at four to five years has been shown to be low in England, potentially increasing the risk of vision disorders not being treated. This study explores vision specialists' views on the perceived barriers and facilitators encountered when engaging with parents and young children, and the strategies adopted to improve child/parent centred care. Fifteen semi-structured qualitative interviews were conducted with eye care professionals to explore perspectives on the challenges of treating children. Thematic analysis was performed to identify key barriers and the strategies eye care professionals adopt to enhance person-centred eye care when working with young children and their families. Two overarching themes were identified related to the professional-patient relationship. The first reflects the challenges which vision specialists experience when treating children, considering lack of eye health education and negative attitudes to diagnosis and treatment as major barriers. The second discusses the strategies adopted to tackle those barriers. Three strategies are proposed to enhance child-centred eye care: more eye health education, more personalised communication to enhance referral uptake and the development of better coordinated pathways of care between schools, communities and hospital services.

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“…A number of studies have shown that visual acuity measurements are the single most important factor for assessing the global visual performance of a child; 4,16 however, when visual acuity testing alone is performed with a sensitivity of 90 per cent, the specificity is only 50 per cent, 17 resulting in significant numbers of false positive results. As a result, the cost‐effectiveness of children's vision screening programs has been questioned in recent years 18,19 …”

mentioning

confidence: 99%

Review of preschool vision screening referrals in South Auckland, New Zealand

Anstice

Spink

Abdul-Rahman

2012

Clinical and Experimental Optometry

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Background: Limited data are available on the causes of visual impairment in preschool children in New Zealand. We aimed to review demographic and visual parameters in children referred to the Ophthalmology Department, Manukau Super Clinic from vision screening programs in South Auckland. Methods: Retrospective medical record review of 131 children, aged three to five years, referred from community-based vision screening programs to the Ophthalmology Department for further assessment. Medical records were reviewed to determine: the reason for referral; findings from ophthalmic assessments; treatment received; and visual acuity at the final visit. The main outcome measures were the cause of visual impairment in children referred from preschool vision screening and the visual acuity at the final follow-up visit. Results: Thirty-eight (29.0 per cent) children were discharged after their initial assessment as false positive referrals. Almost half (45.5 per cent) of the children were prescribed glasses for the correction of refractive error, amblyopia or strabismus. Twentynine (22.1 per cent) children were diagnosed with amblyopia with an average follow-up period of 17.5 Ϯ 2.7 months. In general, compliance with therapy for amblyopia was poor with 48.3 per cent non-compliant with their prescribed treatment regimen. Despite this, visual outcomes were good with an average final visual acuity in the amblyopic eye of 0.294 Ϯ 0.231 logMAR (Snellen 6/12). Conclusions: The 'positive predictive value' for the Counties-Manukau preschool vision screening program was 47.4 per cent, suggesting that the visual acuity measurements alone produce a significant number of false positive results. In children diagnosed with amblyopia, early detection and intervention showed significant improvement in vision in the amblyopic eye, with many children also showing improved binocular function.

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Provision and cost of children's and young people's eye services in the UK: findings from a single primary care trust

Cited by 8 publications

References 25 publications

Out-of-pocket Costs of Disabilities and Their Association with Household Socioeconomic Status Among School-aged Children in Vietnam

Out-of-pocket Costs of Disabilities and Their Association with Household Socioeconomic Status Among School-aged Children in Vietnam

Challenges of Eye Health Care in Children and Strategies to Improve Treatment Uptake: A Qualitative Study from the Perspective of Eye Care Professionals in the UK

Review of preschool vision screening referrals in South Auckland, New Zealand

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