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. 2018 Apr 17;18(1):98.
doi: 10.1186/s12886-018-0761-y.

A cost-effectiveness study of ICT training among the visually impaired in the Netherlands

Nathalie J S Patty  1 , Marc Koopmanschap  2 , Kim Holtzer-Goor  2
Affiliations

A cost-effectiveness study of ICT training among the visually impaired in the Netherlands

Nathalie J S Patty et al. BMC Ophthalmol. .

Abstract

Background: Due to the ageing population, the number of visually impaired people in the Netherlands will increase. To ensure the future availability of services in rehabilitative eye care, we aim to assess the cost-effectiveness of information and communication technology (ICT) training among visually impaired adults from a societal perspective, using primary data from two large rehabilitative eye care providers in the Netherlands.

Methods: Participants were asked to fill in a questionnaire, which used six different instruments at three different time points: pre training, post training and three months post training. We investigated whether the participants' quality of life and well-being improved after the training and whether this improvement persisted three months post training. Economic evaluation was conducted by comparing costs and outcomes before and after training. Quality of life and well-being were derived from the EQ-5D and ICECAP-O, respectively. Costs for productivity losses and medical consumption were obtained from the questionnaires. Information regarding the costs of training sessions was provided by the providers.

Results: Thirty-eight participants filled in all three questionnaires. The mean age at baseline was 63 years (SD = 16). The effect of ICT training on ICT skills and participants' well-being was positive and persisted three months after the last training session. Assuming these effects remain constant for 10 years, this would result in an incremental cost-effectiveness ratio (ICER) of € 11,000 per quality-adjusted life-year (QALY) and € 8000 per year of well-being gained, when only the costs of ICT training are considered. When the total costs of medical consumption are included, the ICER increases to € 17,000 per QALY gained and € 12,000 per year of well-being gained. Furthermore, when the willingness-to-pay threshold is € 20,000 per year of well-being, the probability that ICT training will be cost-effective is 75% (91% when including only the costs of ICT training).

Conclusion: Our study suggests that ICT training among the visually impaired is cost-effective when the effects of ICT training on well-being persist for several years. However, further research involving a larger sample and incorporating long-term effects should be conducted.

Keywords: Cost-effectiveness; Eye care; ICECAP-O; ICT training; Rehabilitation; Visually impaired.

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Conflict of interest statement

Ethics approval and consent to participate

The participants in this study were receiving ‘care as usual’ (ICT training) and only filling in a questionnaire concerning the ICT training. Consequently, the participants were not subjects to a procedure and were not required to follow rules of behavior. As such, this study would not fall under the Dutch Medical Research Involving Human Subjects Act (WMO). At the time when the study was designed (in 2014) consulting with the Medical Ethical Committee was not common in the Netherlands, for studies only concerning filling in questionnaires related to usual care (not involving a new intervention). If this study had taken place in 2018, it would have received a waiver for the study protocol. The Dutch Medical Ethical Committee is however not allowed to give a waiver in 2018 for a study that started in 2014. All respondents were informed about the aims of the study and its anonymous and voluntary nature before giving their consent to participate. Informed consent was obtained from all participants.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of enrollment process, participant dropouts and time points for the questionnaire
Fig. 2
Fig. 2
Cost-effectiveness plane (well-being, total medical costs and costs of ICT training)
Fig. 3
Fig. 3
Acceptability curve for well-being and medical and ICT training costs
See this image and copyright information in PMC

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