1. Reducing the Costs of an Eye Care Adherence Program for Underserved Children Referred Through Inner-City Vision Screenings
- Author
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Seung Ah Chung, Melanie Snitzer, Laura T. Pizzi, Alex V. Levin, Qiang Zhang, and Katherine M. Prioli
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Eye Diseases ,Urban Population ,Aftercare ,Social Workers ,Eye care ,Vulnerable Populations ,03 medical and health sciences ,0302 clinical medicine ,Time frame ,Vision Screening ,Inner city ,Intervention (counseling) ,Screening programs ,medicine ,Humans ,Community Health Services ,Child ,Referral and Consultation ,030304 developmental biology ,Retrospective Studies ,Philadelphia ,0303 health sciences ,Social work ,business.industry ,Infant, Newborn ,Infant ,Retrospective cohort study ,Health Care Costs ,Continuity of Patient Care ,Ophthalmology ,Family medicine ,Child, Preschool ,030221 ophthalmology & optometry ,Patient Compliance ,Female ,Catchment area ,business - Abstract
PURPOSE We previously reported costs and outcomes of the Children's Eye Care Adherence Program (CECAP1), a social worker intervention designed to improve adherence to eye care for underserved children in urban Philadelphia. Using cost findings from CECAP1, we revised the intervention to reduce costs. The aim of this study was to evaluate costs and effectiveness of the revised intervention (CECAP2). DESIGN Retrospective cohort study. METHODS Records of children needing ophthalmic follow-up after 2 community-based vision screening programs were reviewed. We modified CECAP1 to prioritize children more likely to visit, decreased phone calls and scheduling attempts, better documented children already followed by other doctors, and constricted our geographic catchment area for better accessibility. Cost was calculated using time spent executing CECAP2 by our salaried social worker. Effectiveness was defined as the percentage of patients completing at least 1 follow-up visit within the recommended time frame. RESULTS Of 462 children referred to CECAP2 from our in-school and on-campus screening programs, 242 (52.4%) completed subsequent recommended eye examinations, a proportion identical to our prior report (52.3%). Social worker time per patient was 0.8 hours; a significant reduction from the previous 2.6 hours (P < .01). Cost per patient was $32.73; a significant reduction compared to the previous $77.20 (P < .01). CONCLUSIONS Programmatic changes to reduce social worker intervention time and target potential patients by likelihood to attend along with constriction of the catchment area led to reduced costs by more than 50%, without impairing CECAP effectiveness.
- Published
- 2020