{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:26:29Z","timestamp":1787775989277,"version":"build-2784847793"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"2022 Bayer Ophthalmic Care Award"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health\ufffdServ\ufffdInsights"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The TeleTriageTeam (TTT) is a novel system for remote eyecare delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Explores the impact of TTT on costs by depicting program theory of care prioritization. Moreover, a quantification of longer-term effects of delay (and inversely earlier treatment) on costs is performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Mixed-methods health economic evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>First, we depicted the program theory of prioritization into a LOGIC-model using existing TTT-data and expert interviews outlining the causal pathways how and why a program is expected to work. Second, we identified the most relevant key diagnoses to be appraised based on incidence, severity, and presumed triage impact. Third, we estimated the impact of delay (or inversely earlier treatment) on societal costs and quality of life (QoL) based on literature searches. Cost data were updated to 2023. Results were reported per delayed patient per 6\u2009months (the average TTT delay).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Five key diagnoses were selected: cataract, diabetic retinopathy (DRP), age-related macular disease (AMD), glaucoma, and dry-eye-syndrome (DES). The LOGIC-model showed how the TTT actions could influence costs and QoL. Semi-structured interviews revealed delay results in adverse events, at the expense of shorter waiting times in prioritized patients, and overall decreases personnel burden. Reduced waiting times were also believed to decrease burden and costs in prioritized patients. Literature showed that a delay in glaucoma treatment results in savings (\u2212\u20ac409), while the other diagnoses suggested higher societal costs (cataract \u20ac3298, DES \u20ac2156, AMD \u20ac1455, DRP \u20ac117). QoL reduction and increased costs due to delay were more apparent when delay results in longer duration of curable symptoms compared to delay in stable disease (up to 0.09 vs 0.003 QALYs and \u20ac3298 vs \u20ac1455, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Eye care delay results reduced QoL and increased societal costs, yet this is compounded by gains attributable to justified prioritization of more urgent and more severe patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11786329251347684","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T05:08:31Z","timestamp":1750914511000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Remote Eye Triage: Health Economic Perspectives on Resource Prioritization"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2795-2322","authenticated-orcid":false,"given":"Casper","family":"van der Zee","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Medical Center Utrecht, The Netherlands"},{"name":"Department of Epidemiology and Health Economics, Julius Centrum, University Medical Center Utrecht, The Netherlands"},{"name":"Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P. L.","family":"Wisse","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center Utrecht, The Netherlands"},{"name":"Xpert Clinics Oogzorg, Zeist, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia M.","family":"Imhof","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam P.","family":"van der Meulen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Economics, Julius Centrum, University Medical Center Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60355-4"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2011-301378"},{"key":"e_1_3_2_4_2","unstructured":"de Wit GA Oosterhoff M Kouwenberg L Rotteveel AH van Vliet ED. De Gezondheidsgevolgen van Uitgestelde Operaties Tijdens de Corona-Pandemie. Schattingen Voor 2020 En 2021. Rijksinstituut voor Volksgezondheid en Milieu RIVM; 2022. Accessed December 12 2023. https:\/\/rivm.openrepository.com\/handle\/10029\/625900"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2196\/46145"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3310\/hta25570"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.11.032"},{"key":"e_1_3_2_8_2","unstructured":"VGZ. Oogartsen en studenten werken samen aan zorg op afstand - Zinnige Zorg initiatief. VGZ Zorgverzekering. Accessed January 8 2024. https:\/\/www.vgz.nl\/zinnige-zorg\/zinnige-zorg-award-2021\/oogartsen-en-studenten-werken-samen-aan-zorg-op-afstand"},{"key":"e_1_3_2_9_2","volume-title":"Purposeful Program Theory: Effective Use of Theories of Change and Logic Models","author":"Funnell S","year":"2011","unstructured":"Funnell S, Rogers PJ. Purposeful Program Theory: Effective Use of Theories of Change and Logic Models. Jossey-Bass; 2011."},{"key":"e_1_3_2_10_2","unstructured":"Rohwer A Booth A Pfadenhauer L et al Guidance on the use of logic models in health technology assessments of complex interventions 6 CORE View metadata citation and similar papers at core. Published online 2016. Accessed March 18 2025. http:\/\/www.integrate-hta.eu\/downloads\/"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-015-0372-x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X13509406"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2019.01.004"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2012.02.009"},{"key":"e_1_3_2_15_2","unstructured":"Consumer price index (2010\u2009=\u2009100). Data. Accessed January 8 2024. https:\/\/data.worldbank.org\/indicator\/FP.CPI.TOTL?end=2022&name_desc=false&start=1960"},{"key":"e_1_3_2_16_2","unstructured":"OECD. Purchasing power parities for GDP and related indicators. Accessed January 8 2024. https:\/\/stats.oecd.org\/Index.aspx?datasetcode=PPPGDP"},{"key":"e_1_3_2_17_2","unstructured":"OECD iLibrary. Comparing Hospital and Health Prices and Volumes Internationally: Results of a Eurostat\/OECD Project. OECD Health Working Papers. OECD iLibrary. Accessed January 8 2024. https:\/\/www.oecd-ilibrary.org\/social-issues-migration-health\/comparing-hospital-and-health-prices-and-volumes-internationally_5jxznwrj32mp-en"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3310\/CIHR-NIHR-01"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2011.02.023"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029954"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-020-00074-w"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10384-011-0041-3"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2019.02.006"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.118.1.47"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2010.07.010"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1159\/000514539"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-010-1836-3"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0420.2005.00621.x"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12141"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(03)00462-7"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02430.x"},{"key":"e_1_3_2_32_2","article-title":"Annual direct cost of dry eye in Japan","volume":"755","author":"Mizuno Y","year":"2012","unstructured":"Mizuno Y, Yamada M, Shigeyasu C. Annual direct cost of dry eye in Japan. Clin Ophthalmol. 2012;755:S30625","journal-title":"Clin Ophthalmol"},{"key":"e_1_3_2_33_2","unstructured":"Zorginstituut Nederland. Richtlijn voor het uitvoeren van economische evaluaties in de gezondheidszorg. 2024. Accessed February 21 2024. https:\/\/www.zorginstituutnederland.nl\/over-ons\/publicaties\/publicatie\/2024\/01\/16\/richtlijn-voor-het-uitvoeren-van-economische-evaluaties-in-de-gezondheidszorg"},{"key":"e_1_3_2_34_2","unstructured":"CBS StatLine. Werkzame beroepsbevolking; arbeidsduur. 2024. Accessed January 11 2024. https:\/\/opendata.cbs.nl\/#\/CBS\/nl\/dataset\/85275NED\/table"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(03)00450-0"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100852"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/09286580802228509"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2013-304017"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003471"}],"container-title":["Health Services Insights"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11786329251347684","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11786329251347684","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11786329251347684","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:09:19Z","timestamp":1777450159000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11786329251347684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":38,"alternative-id":["10.1177\/11786329251347684"],"URL":"https:\/\/doi.org\/10.1177\/11786329251347684","relation":{},"ISSN":["1178-6329","1178-6329"],"issn-type":[{"value":"1178-6329","type":"print"},{"value":"1178-6329","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]},"article-number":"11786329251347684"}}