An evaluation of a community-based vision care programme for the elderly

• Published in: BMC geriatrics Vol. 22; no. 1; pp. 1 - 711
• Main Authors: Yang, She Chiu, Law, Tsz Kin, Leung, Yan Lok Lucas, Tam, Yim Ying, Sum, Rita, Lian, Jinxiao, Yap, Maurice
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 27-08-2022; BioMed Central; BMC
• Subjects: Acuity; Age factors in disease; Age groups; Aged patients; Aging; Analysis; Care and treatment; Cataracts; Causes of; Cost analysis; Cost benefit analysis; Cost-effectiveness; Councils; Diabetic retinopathy; Elderly population; Eye; Eye diseases; Eye disorders; Geriatrics; Health services research; Macular degeneration; Methods; Older people; Optometry; Population; Services; Software; Subsidies; Vision; Vision care; Visual impairment; Hong Kong; Hong Kong China; China
• DOI: 10.1186/s12877-022-03399-4
• EISSN: 1471-2318

Background This study evaluated the real-world effectiveness and potential cost-effectiveness of a community-based vision care programme for the elderly population aged 60 years or above. Methods Data from a total of 8899 subjects participating in a community-based comprehensive vision care programme from 2015 to 2019 were analysed to evaluate the effectiveness of the programme in terms of the prevalence of distance visual impairment (VI), the change in the prevalence of distance VI after refractive error correction, and the types of ocular disorders suspected. Distance VI was defined as a) visual acuity (VA) worse than 6/18 in any eye (worse eye) and b) VA worse than 6/18 in the better eye. The cost-effectiveness from the funder's perspective was also estimated in terms of cost per distance VI avoided. Results Based on the presenting vision of the worse eye, the prevalence of distance VI was 39.1% (3482/8899, 95% CI: 38.1%-40.1%) and reduced to 13.8% (1227/8899, 95% CI: 13.1%-14.5%) based on best-corrected VA. Referenced to the presenting vision of the better eye, the prevalence of distance VI was 17.3% (1539/8899, 95% CI: 16.5%-18.1%) and decreased to 4.2% (373/8899, 95% CI: 3.8%-4.6%) with best optical correction. Uncorrected refractive error was the major cause of presenting distance VI. From the funder's perspective, the cost per distance VI case prevented was HK$1921 based on VA in the worse eye and HK$3715 based on the better eye. Conclusion This community-based programme identified distance VI in the best eye of 17 out of every 100 subjects. With appropriate new or updated distance optical corrections, distance VI was reduced to about 4 in 100 subjects. Visual impairment in the elderly is common even in a relatively affluent city. A model of care which could minimise avoidable distance VI would bring benefits at individual and societal levels. Keywords: Vision care, Visual impairment, Elderly population, Health services research, Cost-effectiveness