Cost Analysis of a Comprehensive School Eye Screening Model from India.

PURPOSE: School eye screening is a crucial strategy in the elimination of childhood blindness because of its ability to reach out to children who are otherwise inaccessible to eye care needs. Comprehensive screening programs are recommended and are beneficial, but the economic aspects of such models remain to be understood. This study aimed to analyse the cost of a comprehensive school eye screening model while utilizing optometrists and optometry students.

METHODS: This cross-sectional study was conducted for 295 schools screened in the academic year 2018-2019. The analysis was performed from the service provider's perspective including only the direct costs. Financial records were used for cost estimates. The outcome measures were cost per school and child, predictors for the cost, DALYs averted, cost of childhood blindness, and Benefit-Cost Ratio.

RESULTS: A total of 65 094 children underwent screening from 295 schools. The median (IQR) cost per school and child for screening was $29.65 (29.65-44.34) and $0.66 (0.32-1.13). The regression model predicted that the cost of screening was dependent on school strength, number of screening personnel, distance of the schools, and deliverables. With the interventions to improve compliance, 14686.30 DALYs have been averted. Loss of productivity due to childhood blindness was estimated to be $339070.83. Screening for colour vision also had a Benefit-Cost ratio of greater than one.

CONCLUSION: Cost of screening was low and the benefits were high while utilising optometrist and optometry students along with a comprehensive screening protocol.