Resource use and costs of patients with glaucoma or ocular hypertension: Aone-year study based on retrospective chart review in the Netherlands

Purpose: To estimate resource use and costs associated with the diagnosis a nd treatment of glaucoma and ocular hypertension in the Netherlands in 1996 and to determine how costs differed between patients, diagnoses, and hospi tals. Patients and Methods: Patient characteristics and glaucoma-related resource use were collected for 500 patients with glaucoma or ocular hypertension f rom the medical records of 10 hospitals. Costs were calculated by multiplyi ng the health care resource use of each patient with actual unit costs. Mul tiple least-squares regression was used to analyze the relationship between costs and patient characteristics, diagnosis, and type of hospital (genera l or academic). Results: The mean annual frequency of visits to the ophthalmologist for pat ients with ocular hypertension and glaucoma was 2.43 and 3.74, respectively , and the mean cost per patient was $280 and $559, respectively. The mean c ost of patients with glaucoma who had no changes in medication therapy was $347 and increased to $1,765 in patients with more than three adjustments i n medication therapy. Outpatient visits to the ophthalmologist and medicati on contributed most to total costs. Regression analysis showed that costs w ere significantly related to intraocular pressure, diagnosis, severe excava tion of the optic nerve head, and type of hospital. Conclusions: The costs of patients with glaucoma were twice as high as the costs of patients with ocular hypertension. Aside from diagnosis, differenc es in costs between patients could partly be explained by baseline patient characteristics. Patients in academic hospitals had more severe glaucoma an d treatment was considerably more expensive than for patients in nonacademi c hospitals.