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- Title
Effect of Accessible Nonmydriatic Retinal Imaging on Diabetic Retinopathy Surveillance Rates.
- Authors
Jacoba, Cris Martin P.; Cavallerano, Jerry D.; Tolston, Ann M.; Silva, Paolo S.
- Abstract
Purpose:To evaluate the impact on surveillance rates for diabetic retinopathy (DR) by providing nonmydriatic retinal imaging as part of comprehensive diabetes care at no cost to patients or insurers. Methods:A retrospective comparative cohort study was designed. Patients were imaged from April 1, 2016 to March 31, 2017 at a tertiary diabetes-specific academic medical center. Retinal imaging was provided without additional cost beginning October 16, 2016. Images were evaluated for DR and diabetic macular edema using standard protocol at a centralized reading center. Diabetes surveillance rates before and after no-cost imaging were compared. Results:A total of 759 and 2,080 patients respectively were imaged before and after offering no-cost retinal imaging. The difference represents a 274% increase in the number of patients screened. Furthermore, there was a 292% and 261% increase in the number of eyes with mild DR and referable DR, respectively. In the comparative 6-month period, 92 additional cases of proliferative DR were identified, estimated to prevent 6.7 cases of severe visual loss with annual cost savings of $180,230 (estimated yearly cost of severe vision loss per person: $26,900). In patients with referable DR, self-awareness was low, with no significant difference in the before and after groups (39.4% vs. 43.8%, p = 0.3725). Conclusions:Providing retinal imaging as part of comprehensive diabetes care substantially increased the number of patients identified by nearly threefold. The data suggest that the removal of out-of-pocket costs substantially increased patient surveillance rates, which may translate to improved long-term patient outcomes.
- Subjects
DIABETIC retinopathy; RETINAL imaging; ACADEMIC medical centers; MACULAR edema; VISION disorders; MEDICAL care costs
- Publication
Telemedicine & e-Health, 2023, Vol 29, Issue 11, p1667
- ISSN
1530-5627
- Publication type
Article
- DOI
10.1089/tmj.2022.0313