Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stage

Detalhes bibliográficos
Autor(a) principal: Guedes,Ricardo Augusto Paletta
Data de Publicação: 2011
Outros Autores: Guedes,Vanessa Maria Paletta, Chaoubah,Alfredo
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos brasileiros de oftalmologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492011000600003
Resumo: PURPOSE: To assess the resources use, costs and effectiveness of non-penetrating deep sclerectomy (NPDS). METHODS: A retrospective cohort of NPDS patients was analyzed. Eyes were stratified according to glaucoma severity into 3 groups: 1 (early), 2 (moderate) and 3 (severe). NPDS associated resources were based on the frequency of the following variables: surgical procedure (NPDS), intraoperative mitomycin C (MMC); 5-fluorouracil needling (5-FU); Nd:YAG laser goniopuncture; new filtering surgery and medications needed postoperatively. Costs were based on the value and prices of the Brazilian Public Health System and follow-up period was 5 years. Success rate: percentage of patients achieving an end-point intraocular pressure <18 mmHg (and least 20% reduction) without any medications. RESULTS: Percentage of patients using resources in groups 1, 2 and 3 was, respectively: 92.1%, 88.5% and 93.0% for MMC; 10.5%, 11.5% and 13.3% for 5-FU; 18.4%, 19.7% and 21.9% for goniopuncture and 13.2%, 24.6% and 27.3% for a new surgery. Mean number of glaucoma medications per patient at the end of follow-up was 0.42 in group 1 and 0.48 and 0.73 in groups 2 and 3, respectively. Mean NPDS direct cost was US$305.25, US$361.37 and US$390.09 in early, moderate and severe glaucoma, respectively. No differences were found in effectiveness according to glaucoma severity. CONCLUSION: There is a trend in the use of resources and costs in NPDS. The more advanced the glaucoma, the higher the need for resources and the higher the associated costs. NPDS effectiveness did not differ among different glaucoma stages.
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spelling Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stageGlaucomaPrimary open-angle glaucomaFiltering surgeryCostsHealth care costsPURPOSE: To assess the resources use, costs and effectiveness of non-penetrating deep sclerectomy (NPDS). METHODS: A retrospective cohort of NPDS patients was analyzed. Eyes were stratified according to glaucoma severity into 3 groups: 1 (early), 2 (moderate) and 3 (severe). NPDS associated resources were based on the frequency of the following variables: surgical procedure (NPDS), intraoperative mitomycin C (MMC); 5-fluorouracil needling (5-FU); Nd:YAG laser goniopuncture; new filtering surgery and medications needed postoperatively. Costs were based on the value and prices of the Brazilian Public Health System and follow-up period was 5 years. Success rate: percentage of patients achieving an end-point intraocular pressure <18 mmHg (and least 20% reduction) without any medications. RESULTS: Percentage of patients using resources in groups 1, 2 and 3 was, respectively: 92.1%, 88.5% and 93.0% for MMC; 10.5%, 11.5% and 13.3% for 5-FU; 18.4%, 19.7% and 21.9% for goniopuncture and 13.2%, 24.6% and 27.3% for a new surgery. Mean number of glaucoma medications per patient at the end of follow-up was 0.42 in group 1 and 0.48 and 0.73 in groups 2 and 3, respectively. Mean NPDS direct cost was US$305.25, US$361.37 and US$390.09 in early, moderate and severe glaucoma, respectively. No differences were found in effectiveness according to glaucoma severity. CONCLUSION: There is a trend in the use of resources and costs in NPDS. The more advanced the glaucoma, the higher the need for resources and the higher the associated costs. NPDS effectiveness did not differ among different glaucoma stages.Conselho Brasileiro de Oftalmologia2011-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492011000600003Arquivos Brasileiros de Oftalmologia v.74 n.6 2011reponame:Arquivos brasileiros de oftalmologia (Online)instname:Conselho Brasileiro de Oftalmologia (CBO)instacron:CBO10.1590/S0004-27492011000600003info:eu-repo/semantics/openAccessGuedes,Ricardo Augusto PalettaGuedes,Vanessa Maria PalettaChaoubah,Alfredoeng2012-02-10T00:00:00Zoai:scielo:S0004-27492011000600003Revistahttp://aboonline.org.br/https://old.scielo.br/oai/scielo-oai.phpaboonline@cbo.com.br||abo@cbo.com.br1678-29250004-2749opendoar:2012-02-10T00:00Arquivos brasileiros de oftalmologia (Online) - Conselho Brasileiro de Oftalmologia (CBO)false
dc.title.none.fl_str_mv Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stage
title Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stage
spellingShingle Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stage
Guedes,Ricardo Augusto Paletta
Glaucoma
Primary open-angle glaucoma
Filtering surgery
Costs
Health care costs
title_short Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stage
title_full Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stage
title_fullStr Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stage
title_full_unstemmed Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stage
title_sort Resources use, costs and effectiveness of non-penetrating deep sclerectomy according to glaucoma stage
author Guedes,Ricardo Augusto Paletta
author_facet Guedes,Ricardo Augusto Paletta
Guedes,Vanessa Maria Paletta
Chaoubah,Alfredo
author_role author
author2 Guedes,Vanessa Maria Paletta
Chaoubah,Alfredo
author2_role author
author
dc.contributor.author.fl_str_mv Guedes,Ricardo Augusto Paletta
Guedes,Vanessa Maria Paletta
Chaoubah,Alfredo
dc.subject.por.fl_str_mv Glaucoma
Primary open-angle glaucoma
Filtering surgery
Costs
Health care costs
topic Glaucoma
Primary open-angle glaucoma
Filtering surgery
Costs
Health care costs
description PURPOSE: To assess the resources use, costs and effectiveness of non-penetrating deep sclerectomy (NPDS). METHODS: A retrospective cohort of NPDS patients was analyzed. Eyes were stratified according to glaucoma severity into 3 groups: 1 (early), 2 (moderate) and 3 (severe). NPDS associated resources were based on the frequency of the following variables: surgical procedure (NPDS), intraoperative mitomycin C (MMC); 5-fluorouracil needling (5-FU); Nd:YAG laser goniopuncture; new filtering surgery and medications needed postoperatively. Costs were based on the value and prices of the Brazilian Public Health System and follow-up period was 5 years. Success rate: percentage of patients achieving an end-point intraocular pressure <18 mmHg (and least 20% reduction) without any medications. RESULTS: Percentage of patients using resources in groups 1, 2 and 3 was, respectively: 92.1%, 88.5% and 93.0% for MMC; 10.5%, 11.5% and 13.3% for 5-FU; 18.4%, 19.7% and 21.9% for goniopuncture and 13.2%, 24.6% and 27.3% for a new surgery. Mean number of glaucoma medications per patient at the end of follow-up was 0.42 in group 1 and 0.48 and 0.73 in groups 2 and 3, respectively. Mean NPDS direct cost was US$305.25, US$361.37 and US$390.09 in early, moderate and severe glaucoma, respectively. No differences were found in effectiveness according to glaucoma severity. CONCLUSION: There is a trend in the use of resources and costs in NPDS. The more advanced the glaucoma, the higher the need for resources and the higher the associated costs. NPDS effectiveness did not differ among different glaucoma stages.
publishDate 2011
dc.date.none.fl_str_mv 2011-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492011000600003
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S0004-27492011000600003
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Conselho Brasileiro de Oftalmologia
publisher.none.fl_str_mv Conselho Brasileiro de Oftalmologia
dc.source.none.fl_str_mv Arquivos Brasileiros de Oftalmologia v.74 n.6 2011
reponame:Arquivos brasileiros de oftalmologia (Online)
instname:Conselho Brasileiro de Oftalmologia (CBO)
instacron:CBO
instname_str Conselho Brasileiro de Oftalmologia (CBO)
instacron_str CBO
institution CBO
reponame_str Arquivos brasileiros de oftalmologia (Online)
collection Arquivos brasileiros de oftalmologia (Online)
repository.name.fl_str_mv Arquivos brasileiros de oftalmologia (Online) - Conselho Brasileiro de Oftalmologia (CBO)
repository.mail.fl_str_mv aboonline@cbo.com.br||abo@cbo.com.br
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