Cost Analysis of Orthoptist-Led Neurofibromatosis Type 1 Screening Clinic
Journal Club: Elizabeth Gately-Taylor
Date: Nov 2024
For me the key to this article is that allied health led clinics are proven to be cost effective and time efficient.
From a patient’s perspective, the opportunity cost of their time is also significant. Spending 20 minutes less at the clinic with a clinician is likely to be welcomed by patients and their families (Ballantyne et al. 2019). Shorter appointment times without compromising the quality of care encourages families to accept future allied health-led clinic appointments (Pokorny et al. 2021. From a hospital’s perspective, our findings support the allocation of resources to an allied health-led clinic as a judicious use of hospital resources. Therefore, allied health-led clinics are indicative of cost and time-efficient alternate care models from both a healthcare and patient viewpoint.
As we see several patients with NF1 it also served as a useful reminder of why we screen.
OPGs occur in approximately 15% of patients with NF1 (Fisher et al. 2012), with the greatest risk of developing within the first six years of life (Listernick et al. 1994). Symptoms of an OPG include decreased visual acuity, abnormal pupillary functions, decreased colour vision, optic atrophy, reduced visual field, and proptosis (Suharwardy & Elston 1997). The main objective in the management of patients with NF1 and an OPG is to prevent decreased visual acuity and neurological damage (Fried et al. 2013). Vision reduction can be unilateral or asymmetrical and children may not complain of vision problems as they readily adapt to this change. Therefore screening for an OPG in patients with NF1 is crucial (Thiagalingam et al. 2004).
Does anybody in NZ run clinics that are not strictly “orthoptic”?
I used to do glaucoma screening and plaquenil toxicity screening but not recently.
Article access here
One response to “Nov 2024: Cost Analysis of Orthoptist-Led Neurofibromatosis Type 1 Screening Clinic”
I know the MOH is looking into more allied health led ‘physican extender’ clinics to release the overstretched SMO clinics.
But currently these children are monitored in a normal orthoptic workload. However here in the provinces they do not receive consultant appts just annual orthoptic va checks and only if down Do fundi exams.
This australian review shows good utilisation and cost effectiveness.