Clinical performance analysis and cost-utility analysis of a mobile cataract surgery service in a rural setting in Thailand
Purpose: To evaluate a clinical performance and cost-effectiveness of a mobile cataract surgery service, specifically and separately for Phacoemulsification (Phaco) and extracapsular cataract extraction (ECCE) Design: A pre-post study with individual-level data Methods: Patients diagnosed with advan...
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Elsevier
2025-04-01
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| Series: | AJO International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950253525000127 |
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| author | Mantapond Ittarat Wanrudee Isaranuwatchai Sunee Chansangpetch |
| author_facet | Mantapond Ittarat Wanrudee Isaranuwatchai Sunee Chansangpetch |
| author_sort | Mantapond Ittarat |
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| description | Purpose: To evaluate a clinical performance and cost-effectiveness of a mobile cataract surgery service, specifically and separately for Phacoemulsification (Phaco) and extracapsular cataract extraction (ECCE) Design: A pre-post study with individual-level data Methods: Patients diagnosed with advanced cataracts underwent cataract surgery at a mobile cataract surgery service. Data on corrected distance visual acuity (CDVA), quality of life (QOL) assessed by EQ-5D-5L questionnaire, and cost were prospectively collected at and compared between baseline and 3 months after treatment. Linear regression was used to analyze the clinical performance, and a cost-utility analysis (CUA) was conducted to show the cost-effectiveness of the mobile service. Results: A total of 98 eyes from 98 patients had cataract surgeries, with 53 patients (54 %) undergoing Phaco techniques and 45 patients (46 %) undergoing ECCE techniques. For the total cohort, LogMAR CDVA changed from 1.88±0.59 to 0.23±0.23 (p < 0.001) with only one case of complication. Significant improvements of mobility and usual activities QOL scores, and utility values were demonstrated (all p < 0.001). Separate CUAs by technique with pre-post data showed that patients with Phaco gained 4.93 QALYs and costed approximately THB 18,800 (USD 535) and patients with ECCE gained 5.45 QALYs with the cost of THB 14,400 (USD 412). Conclusions: A mobile cataract surgery service is effective in improving vision and QOL with a low complication rate. The CUAs showed that both Phaco and ECCE could be cost-effective. Implementing such services in rural areas could be a strategy to increase effective cataract surgery coverage. |
| format | Article |
| id | doaj-art-ab0f7306c20b49f6908faa01e895ddaf |
| institution | OA Journals |
| issn | 2950-2535 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AJO International |
| spelling | doaj-art-ab0f7306c20b49f6908faa01e895ddaf2025-08-20T02:02:06ZengElsevierAJO International2950-25352025-04-012110010910.1016/j.ajoint.2025.100109Clinical performance analysis and cost-utility analysis of a mobile cataract surgery service in a rural setting in ThailandMantapond Ittarat0Wanrudee Isaranuwatchai1Sunee Chansangpetch2Surin Hospital and Surin Medical Education Center, Surin, Thailand; School of Ophthalmology, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand; Corresponding author at: 68 Lak-Muaeng road, Nai-Muaeng, Muaeng, Surin, 32000, Thailand.Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand; Institute of Health Policy, Management and Evaluation, University of Toronto, M5T 3M6, CanadaCenter of Excellence in Glaucoma, Chulalongkorn University, Bangkok, Thailand; Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandPurpose: To evaluate a clinical performance and cost-effectiveness of a mobile cataract surgery service, specifically and separately for Phacoemulsification (Phaco) and extracapsular cataract extraction (ECCE) Design: A pre-post study with individual-level data Methods: Patients diagnosed with advanced cataracts underwent cataract surgery at a mobile cataract surgery service. Data on corrected distance visual acuity (CDVA), quality of life (QOL) assessed by EQ-5D-5L questionnaire, and cost were prospectively collected at and compared between baseline and 3 months after treatment. Linear regression was used to analyze the clinical performance, and a cost-utility analysis (CUA) was conducted to show the cost-effectiveness of the mobile service. Results: A total of 98 eyes from 98 patients had cataract surgeries, with 53 patients (54 %) undergoing Phaco techniques and 45 patients (46 %) undergoing ECCE techniques. For the total cohort, LogMAR CDVA changed from 1.88±0.59 to 0.23±0.23 (p < 0.001) with only one case of complication. Significant improvements of mobility and usual activities QOL scores, and utility values were demonstrated (all p < 0.001). Separate CUAs by technique with pre-post data showed that patients with Phaco gained 4.93 QALYs and costed approximately THB 18,800 (USD 535) and patients with ECCE gained 5.45 QALYs with the cost of THB 14,400 (USD 412). Conclusions: A mobile cataract surgery service is effective in improving vision and QOL with a low complication rate. The CUAs showed that both Phaco and ECCE could be cost-effective. Implementing such services in rural areas could be a strategy to increase effective cataract surgery coverage.http://www.sciencedirect.com/science/article/pii/S2950253525000127Cataract surgeryMobile cataract surgeryCost-utility analysisQuality of lifePublic health |
| spellingShingle | Mantapond Ittarat Wanrudee Isaranuwatchai Sunee Chansangpetch Clinical performance analysis and cost-utility analysis of a mobile cataract surgery service in a rural setting in Thailand AJO International Cataract surgery Mobile cataract surgery Cost-utility analysis Quality of life Public health |
| title | Clinical performance analysis and cost-utility analysis of a mobile cataract surgery service in a rural setting in Thailand |
| title_full | Clinical performance analysis and cost-utility analysis of a mobile cataract surgery service in a rural setting in Thailand |
| title_fullStr | Clinical performance analysis and cost-utility analysis of a mobile cataract surgery service in a rural setting in Thailand |
| title_full_unstemmed | Clinical performance analysis and cost-utility analysis of a mobile cataract surgery service in a rural setting in Thailand |
| title_short | Clinical performance analysis and cost-utility analysis of a mobile cataract surgery service in a rural setting in Thailand |
| title_sort | clinical performance analysis and cost utility analysis of a mobile cataract surgery service in a rural setting in thailand |
| topic | Cataract surgery Mobile cataract surgery Cost-utility analysis Quality of life Public health |
| url | http://www.sciencedirect.com/science/article/pii/S2950253525000127 |
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