Screening for congenital cataracts: a cost-consequence analysis of eye examination at maternity wards in comparison to well-baby clinics.

AIM To estimate, on a national basis in Sweden, the costs versus consequences of combined maternity ward and well-baby clinic eye screening compared to well-baby clinic screening alone. METHODS Two scenarios were created and compared regarding healthcare costs: visual acuity development and quality-adjusted life-years (QALYs). One scenario represented early management (combined maternity ward and well-baby clinic screening); the other represented less early management (well-baby clinic screening only). Each scenario was based on 100,000 births, and the healthcare costs were calculated from detection until age 18 y. All estimates of prevalence, visual outcome, postoperative complications and screening procedures were based on previous, recently published studies. Estimated costs were obtained from St. Erik's Eye Hospital in Stockholm and the University Hospital of Lund, at 2001 prices. RESULTS Total cost of the maternity ward/well-baby clinic screening scenario was 7.9 million SEK, and that of the maternity ward screening scenario was 6.9 million SEK. The incremental cost-effectiveness ratio was estimated at 234,000 SEK/QALY provided three more children per year were detected in Sweden by mandatory maternity ward/well-baby clinic screening. CONCLUSION The incremental expense of introducing combined maternity ward/well-baby clinic eye screening on a nationwide basis is cost effective and within acceptable levels of cost/QALY when compared with other widely accepted therapies across diverse medical specialties.