Health economic consequences of interventions for undetected visual impairment in older adults
Jad Shedrawy,
Sara Olofsson,
Sofie Persson,
Carina Göransson,
Ilze Lace,
Birte Bay Højsted and
Jeanette Källstrand
Additional contact information
Jad Shedrawy: IHE - The Swedish Institute for Health Economics
Sara Olofsson: IHE - The Swedish Institute for Health Economics
Sofie Persson: IHE - The Swedish Institute for Health Economics
Carina Göransson: School of health and welfare, Halmstad University, Halmstad, Sweden
Ilze Lace: School of health and welfare, Halmstad University, Halmstad, Sweden
Birte Bay Højsted: Clinical Research Unit, Department of Ophthalmology, Zealand University
Jeanette Källstrand: School of health and welfare, Halmstad University, Halmstad, Sweden
No 2025:17, IHE Report / IHE Rapport from IHE - The Swedish Institute for Health Economics
Abstract:
Visual impairment is a growing public health challenge in ageing societies. Many older adults live with undetected vision problems that affect daily functioning, safety, and independence. This new report from the IHE investigates the clinical, economic, and quality-of-life consequences of systematic vision screening among adults aged 75 and older in Sweden and Denmark.
The study was carried out within the EU-funded Interreg Undetected Visual Impairment project and includes data from primary care, optician settings, and homecare services.
Key findings
High prevalence of undetected visual impairment was found across all settings.
Vision problems were common even among individuals who had checked their eyesight within the past year.
A large share of participants were recommended further clinical assessment, and about two-thirds followed these recommendations.
Most follow-up treatments involved minor corrective measures, such as new glasses, while a smaller number required medical treatment.
Economic perspective
The report provides detailed estimates of both direct screening costs and broader societal costs related to visual impairment.
The direct cost of screening was estimated at approximately 375–520 SEK per person, depending on setting and staff time.
The most expensive screening component was fundus photography.
Falls related to visual impairment were uncommon but costly, with an average estimated cost of 92,800 SEK per fall.
Informal care generated additional societal costs, even though most participants remained largely independent.
These results highlight how even a small number of preventable injuries or care needs can lead to substantial economic consequences, however the screening programs did not show any impact on the prevalence of falls/injuries.
Quality of life
Vision-related quality of life was measured using the NEI VFQ-25 and converted into health utility values for economic analysis.
Health-related quality of life remained relatively stable over six months, however it decreased for some subgroups.
No clear improvements were observed following screening, likely due to:
• Short follow-up time
• baseline health status
• Lack of a control group
The study therefore cannot determine whether screening leads to measurable quality-of-life gains.
Why this matters
Systematic vision screening has the potential to:
• Detect problems earlier
• Prevent avoidable falls and injuries
• Support safe ageing at home
• Reduce long-term healthcare and care needs
However, the report concludes that larger studies with longer follow-up and control groups are needed to determine whether vision screening is cost-effective.
Keywords: older adults; visual impairment; screening; vision test; Costs and disease burden; Kostnader och sjukdomsbörda; elderly care; synnedsättning; äldre (search for similar items in EconPapers)
Pages: 38 pages
Date: 2025
New Economics Papers: this item is included in nep-age
References: Add references at CitEc
Citations:
Downloads: (external link)
https://ihe.se/app/uploads/2025/12/IHE-REPORT-2025_17_.pdf Full text (application/pdf)
Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
HTML/Text
Persistent link: https://EconPapers.repec.org/RePEc:hhs:ihewps:2025_017
Access Statistics for this paper
More papers in IHE Report / IHE Rapport from IHE - The Swedish Institute for Health Economics
Bibliographic data for series maintained by Annette Persson Dietmann ().