![]() Therefore, it is worthwhile to explore how much the elderly people could benefit from RRD surgery and whether performing RRD surgery is cost-effective in this population. However, the cost-effectiveness of RRD surgery for elderly patients has not been evaluated in the existing literatures.Īs we enter an aging society, along with the popularity of cataract surgery and high rates of myopia, we anticipate a greater number of elderly patients suffering from RRD. In Shanghai, the costs/QALY were 13,794 CNY (2,193 USD)/QALY for normal RRD patients throughout their life expectancies. In the recent American study, the costs/QALY varied from 1,377 USD/QALY to 2,243 USD/QALY for scleral buckling and vitreous surgery. In Brown’s study, the costs/QALY were between 40,252 USD/QALY and 62,383 USD/QALY for vitreous surgery in patients complicated with severe proliferative vitreoretinopathy. Therefore, policymakers can identify relative priorities when determining resource allocation among medical interventions. One advantage of cost-utility analysis is that it allows comparison among different disciplines by a common unit of measure (costs/QALY). ![]() Ĭost-utility analysis is one method of economic evaluation that incorporates the utility value in the form of quality-adjusted life years (QALYs) with costs to calculate how much money should be spent on each QALY gained for certain medical interventions. As shown in a survey of a community population aged over 60 years in Shanghai, retinal detachment was the fifth leading cause of blindness. These elderly people will definitely experience severe visual impairment, and as a result, losses of quality of life. Therefore, in clinical practice, it is not unusual that many elderly people give up on the surgery considering the expensive medical costs, the uncertain visual outcomes, and the relatively short remaining life years. As demonstrated in many previous studies, patients of older age have inferior functional results, namely best-corrected visual acuity, than younger patients –. However, age was also a negative predictor for optimal visual outcomes after RRD surgery. In a recent study conducted in the Netherlands, the annual incidence of RRD was reported to be 21.43 per 100,000 for people aged 85–89 years old. In elderly people who are 70 to 79 years old, the incidences vary from 15.21 to 50 per 100,000 worldwide. The annual incidence of RRD ranged from 6.3 to 17.9 per 100,000 population globally. ![]() Although comparatively lower than the cost reported in America, it is still a large burden for most families in China. In our previous study, an average cost of 11,384 Chinese Yuan (CNY) (1,810 USD, 1 USD = 6.29 CNY, 2012.12.31) was determined for RRD surgery in Shanghai. Two recent studies performed in America calculated the costs for the two types of surgery varying from 4,048 USD to 7,940 USD. Brown and associates reported the costs for vitreoretinal surgery to be between 7,109 US dollars (USD) and 9,607 USD in patients with severe proliferative vitreoretinopathy. Despite the effectiveness of RRD surgery, the costs are not small. However, in most developing countries with limited medical resources, the treatment for retinal detachment has been a low priority. Proper and timely treatments, such as scleral buckling surgery and vitreous surgery, can largely restore visual acuity and permit a certain degree of improvement in vision-related quality of life. Rhegmatogenous retinal detachment (RRD) is the most common type of retinal detachment, and it severely threatens visual acuity and vision-related quality of life –. ![]()
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