Page 43 - DISINVESTMENT AND IMPLEMENTATION OF VISION SCREENING TESTS BASED ON THEIR EFFECTIVENESS

Inventory of current EU paediatric vision and hearing screening programmes
The wide differences between European screening programmes may have occurred because these programmes arose piecemeal, before robust evidence on effectiveness and cost-effectiveness was available to guide protocol design or implementation. In addition, most preventive health care programmes are government funded and, therefore, competition is lower than in curative health-care. Further assessment is needed on the influence of funding source (eg. state, health insurance, or municipalities) on the efficiency of screening.
Further study should also be undertaken into the relative costs and effectiveness of different approaches to screening, as in Europe, 12 different VA charts are used, 10 professions are involved in vision screening, one to four hearing screening tests take place before referral, and eight funding sources are involved. The large number of screening tests used in vision screening should be compared. Efficiency of screening (ie. sensitivity and specificity per euro) should be calculated for screening performed by different screening professions.
We now plan to include data sources in a much larger and more detailed questionnaire. The EUS€REEN study group, an EU-wide consortium (see list at end of paper), is currently preparing a Europe-wide study to compare and optimize the cost- effectiveness of vision and hearing screening, and give country-specific advice in all candidate, associate, and full EU-member states.
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