Falls and health status in elderly women following first eye cataract surgery: an economic evaluation conducted alongside a randomised controlled trial
Falls and health status in elderly women following first eye cataract surgery: an economic evaluation conducted alongside a randomised controlled trial
AIM: To evaluate the cost-effectiveness of first eye cataract surgery compared with no surgery from a health service and personal social services perspective.
METHODS: An economic evaluation undertaken alongside a randomised controlled trial of first eye cataract surgery in secondary care ophthalmology clinics. A sample of 306 women over 70 years old with bilateral cataracts was randomised to cataract surgery (expedited, approximately four weeks) or control (routine, 12 months wait); 75% of participants had baseline acuity of 6/12 or better. Outcomes included falls and the EuroQol EQ-5D.
RESULTS: The operated group cost a mean pounds sterling 2004 (bootstrapped) more than the control group over one year (95% confidence interval (CI), pounds sterling 1363 to pounds sterling 2833) (p<0.001), but experienced on average 0.456 fewer falls, an incremental cost per fall prevented of pounds sterling 4390. The bootstrapped mean gain in quality adjusted life years (QALYs) per patient was 0.056 (95% CI, 0.006 to 0.108) (p<0.001). The incremental cost-utility ratio was pounds sterling 35 704, above the currently accepted UK threshold level of willingness to pay per QALY of pounds sterling 30 000. However, in an analysis modelling costs and benefits over patients' expected lifetime, the incremental cost per QALY was pounds sterling 13 172, under conservative assumptions.
CONCLUSIONS: First eye cataract surgery, while cost-ineffective over the trial period, was probably cost-effective over the participants' remaining lifetime.
Accidental Falls/prevention & control, Aged, Cataract/physiopathology, Cataract Extraction/economics, Cost-Benefit Analysis, Female, Health Care Costs, Health Status, Humans, Models, Economic, Postoperative Period, Quality-Adjusted Life Years, Visual Acuity
1675-9
Sach, Tracey H
5c09256f-ebed-4d14-853a-181f6c92d6f2
Foss, Alexander J E
a7a41307-2028-4f14-8319-b27d6491fa8c
Gregson, Richard M
e2d28fef-9b07-4712-bc7d-48ec27cb91a9
Zaman, Anwar
d9279acc-3bec-4d32-b625-5ffb685e4c29
Osborn, Francis
c27bd233-9053-41ba-b017-ab6f4d2597c0
Masud, Tahir
ef1fc17c-f133-4635-82bb-547b58521ceb
Harwood, Rowan H
ecf3a13f-9699-44ec-98db-0db3f26ae1ed
December 2007
Sach, Tracey H
5c09256f-ebed-4d14-853a-181f6c92d6f2
Foss, Alexander J E
a7a41307-2028-4f14-8319-b27d6491fa8c
Gregson, Richard M
e2d28fef-9b07-4712-bc7d-48ec27cb91a9
Zaman, Anwar
d9279acc-3bec-4d32-b625-5ffb685e4c29
Osborn, Francis
c27bd233-9053-41ba-b017-ab6f4d2597c0
Masud, Tahir
ef1fc17c-f133-4635-82bb-547b58521ceb
Harwood, Rowan H
ecf3a13f-9699-44ec-98db-0db3f26ae1ed
Sach, Tracey H, Foss, Alexander J E, Gregson, Richard M, Zaman, Anwar, Osborn, Francis, Masud, Tahir and Harwood, Rowan H
(2007)
Falls and health status in elderly women following first eye cataract surgery: an economic evaluation conducted alongside a randomised controlled trial.
British Journal of Ophthalmology, 91 (12), .
(doi:10.1136/bjo.2007.118687).
Abstract
AIM: To evaluate the cost-effectiveness of first eye cataract surgery compared with no surgery from a health service and personal social services perspective.
METHODS: An economic evaluation undertaken alongside a randomised controlled trial of first eye cataract surgery in secondary care ophthalmology clinics. A sample of 306 women over 70 years old with bilateral cataracts was randomised to cataract surgery (expedited, approximately four weeks) or control (routine, 12 months wait); 75% of participants had baseline acuity of 6/12 or better. Outcomes included falls and the EuroQol EQ-5D.
RESULTS: The operated group cost a mean pounds sterling 2004 (bootstrapped) more than the control group over one year (95% confidence interval (CI), pounds sterling 1363 to pounds sterling 2833) (p<0.001), but experienced on average 0.456 fewer falls, an incremental cost per fall prevented of pounds sterling 4390. The bootstrapped mean gain in quality adjusted life years (QALYs) per patient was 0.056 (95% CI, 0.006 to 0.108) (p<0.001). The incremental cost-utility ratio was pounds sterling 35 704, above the currently accepted UK threshold level of willingness to pay per QALY of pounds sterling 30 000. However, in an analysis modelling costs and benefits over patients' expected lifetime, the incremental cost per QALY was pounds sterling 13 172, under conservative assumptions.
CONCLUSIONS: First eye cataract surgery, while cost-ineffective over the trial period, was probably cost-effective over the participants' remaining lifetime.
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More information
Published date: December 2007
Keywords:
Accidental Falls/prevention & control, Aged, Cataract/physiopathology, Cataract Extraction/economics, Cost-Benefit Analysis, Female, Health Care Costs, Health Status, Humans, Models, Economic, Postoperative Period, Quality-Adjusted Life Years, Visual Acuity
Identifiers
Local EPrints ID: 480801
URI: http://eprints.soton.ac.uk/id/eprint/480801
ISSN: 0007-1161
PURE UUID: 5321653c-3e3d-4eed-9b64-6322719a2a3b
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Date deposited: 09 Aug 2023 17:14
Last modified: 17 Mar 2024 04:20
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Contributors
Author:
Tracey H Sach
Author:
Alexander J E Foss
Author:
Richard M Gregson
Author:
Anwar Zaman
Author:
Francis Osborn
Author:
Tahir Masud
Author:
Rowan H Harwood
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