The Cost-effectiveness of Screening for Diabetic Retinopathy in Hong Kong
1 other identifier
interventional
4,644
1 country
3
Brief Summary
Introduction: There is no debate that people with diabetes should be screened for the development of retinopathy which can threaten their sight. However, there is no routine screening for retinopathy in Hong Kong at present. Many overseas countries find that they miss a large proportion of their target population and, with reliance on co-payments for screening, as is the case with the limited opportunistic screening at present, the cost-effectiveness of any routine service in Hong Kong could be reduced as is predicted by Hart's inverse care law. Aim: This study will determine the potential cost-effectiveness of screening for retinopathy in Hong Kong under a free system and one in which a co-payment is charged. Methods: Primary care patients attending General Outpatient Clinics on Hong Kong Island for their routine diabetic care will randomly be offered screening either at no charge or with the normal co-payment of $65. Those who are willing and unwilling to be screened will be compared for their clinical, lifestyle and socioeconomic characteristics and those unwilling will be asked their reasons. The uptake of screening at no fee and with a payment will be compared as will the prevalence of retinopathy in the two fee groups. Subsequent screening at one year will be offered at the same fee and uptake again compared. The principal analyses will (a) identify the characteristics of those willing to be screened and reasons for not being screened (b) the uptake of screening when a co-payment is charged compared to when it is free (c) whether there is a difference in the prevalence of retinopathy between the group willing to pay and those who accept free screening and (d) the uptake of re-screening in year 2. The resulting cost-effectiveness model will use these data, the cost data collected during the study and overseas data on benefits of treatment to model the cost-effectiveness of screening for retinopathy in Hong Kong if it were to be offered free or with a co-payment. This information will be important to determine the most cost-effective means of implementing this preventative strategy to preserve sight and quality of life.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Feb 2009
3 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
February 1, 2009
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 1, 2009
CompletedStudy Completion
Last participant's last visit for all outcomes
August 1, 2010
CompletedFirst Submitted
Initial submission to the registry
June 15, 2012
CompletedFirst Posted
Study publicly available on registry
June 26, 2012
CompletedJune 26, 2012
June 1, 2012
6 months
June 15, 2012
June 21, 2012
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Retinopathy profile in the two groups
The extent of diabetic retinopathy in two groups were measured in the first year screening.
the first year
Secondary Outcomes (3)
Subjects' attendance of the screening
the first year
Retinopathy profile in the two groups
the second year
Subjects' attendance of the screening
the second year
Study Arms (2)
free screening group
OTHERSubjects in this group receive free diabetic retinopathy screening.
Pay screening group
OTHERSubjects in this group receive diabetic retinopathy screening with charging a co-payment.
Interventions
The intervention is charging a co-payment of HK$60 for the Diabetic Retinopathy screening.
The intervention is to provide free screening without charging a co-payment
Eligibility Criteria
You may qualify if:
- All diabetic patients who attend the clinic during the study period.
You may not qualify if:
- Only if not competent to give informed consent
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (3)
Aberdeen General Outpatient Clinic,Hospital Authority
Hong Kong, China
Department of Community Medicine,The University of Hong Kong
Hong Kong, China
Eye Institute, Faculty of Medicine, The University of Hong Kong, Hong Kong
Hong Kong, China
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Sarah M McGhee, PhD
The University of Hong Kong
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
June 15, 2012
First Posted
June 26, 2012
Study Start
February 1, 2009
Primary Completion
August 1, 2009
Study Completion
August 1, 2010
Last Updated
June 26, 2012
Record last verified: 2012-06