Resource Use and Costs of Patients With Glaucoma or Ocular Hypertension: A One-year Study Based on Retrospective Chart Review in the Netherlands

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Abstract
To estimate resource use and costs associated with the diagnosis and treatment of glaucoma and ocular hypertension in the Netherlands in 1996 and to determine how costs differed between patients, diagnoses, and hospitals. Patient characteristics and glaucoma-related resource use were collected for 500 patients with glaucoma or ocular hypertension from the medical records of 10 hospitals. Costs were calculated by multiplying the health care resource use of each patient with actual unit costs. Multiple least-squares regression was used to analyze the relationship between costs and patient characteristics, diagnosis, and type of hospital (general or academic). The mean annual frequency of visits to the ophthalmologist for patients 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 cost 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 in medication therapy. Outpatient visits to the ophthalmologist and medication contributed most to total costs. Regression analysis showed that costs were significantly related to intraocular pressure, diagnosis, severe excavation of the optic nerve head, and type of hospital. The costs of patients with glaucoma were twice as high as the costs of patients with ocular hypertension. Aside from diagnosis, differences in costs between patients could partly be explained by baseline patient characteristics. Patients in academic hospitals had more severe glaucoma and treatment was considerably more expensive than for patients in nonacademic hospitals.