Dear Readers,
One of the important barriers to eye care from the patient perspective is the cost of eye care. On the other side of the coin is the providers financial viability to offer the best services in a cost effective manner. This particular issue of Sitenews focuses on Cost of Eye Care. The initial section introduces us to this topic of Cost of Eye Care. Several research studies have been done in the different areas of Cost Effectiveness, Cost Utility Analysis, as well as Costing of Eye Care Equipments.

From this issue of Sitenews we are introducing two new sections: History of Ophthalmology which takes up back in time and reports about eye care as it was in an earlier time period and also the Featured personality where we look forward to highlighting individuals who have made a mark in their field.

As always we look forward to receiving your feedback on this issue as well as what are you would like to see featured in Sitenews.

Wish you a productive reading!

Happy reading!


Vision 2020 e-resource team
The Issue Features...
Vol. 6 No. 10 October 2009
•   Cost of Eye Care
•   Cost Effectiveness of Eye Care
•   Cost Utility Analysis
•   Costing of Eye Care Equipments
•   History of Ophthalmology
•   Featured Personality
•   Featured Organisation
•   Talk to Us
•   Past Issues


The Global Initiative for the Elimination of Avoidable Blindness (VISION 2020: The Right to Sight) sets a major challenge requiring a significant increase in the provision and uptake of eye care services. If the increasing trend in blindness is to be reversed, then access to eye care services needs to be made more widely available. One of the most significant barriers to accessing these services is affordability. The shrinking economies of many of the world's poorest countries is placing increasing pressure on health care budgets that are already severely over stretched. Competing demands from life threatening diseases such as AIDS, malaria, and TB are pushing eye health services further down the agenda list of public health priorities. Simultaneously, the increasing cost of health care is forcing many governments to reform the structure of their health delivery systems. Many are choosing to introduce cost recovery mechanisms, as a means of controlling the overall rising costs of providing health care services.


  • This articles main focus is on the cost containment in the hospital. It describes in detail the areas to focus while fixing the patient fees. It also lists out the various factors which contribute to the cost containment in Eye Hospitals.


  • This Article focus primarily on the supply issues of service delivery, looking particularly at how increasing operational and manufacturing efficiencies can reduce costs to an affordable level to reach the goal of Vision2020


  • This article highlights some of the core concepts of a strong, practical VISION 2020 programme to be considered when preparing a budget. This article also describes in detail about budgeting the variable cost needed for the infrastructure and healthcare requirements for the planned service population.


  • This article discusses some important aspects of the IEF model which establishes professional optical businesses that can be accessed by anyone, regardless of socioeconomic background.


  • This presentation gives a brief overview of cost control in medical care in the hospitals. It also tells about the objectives of medical care in hospitals, strategies involves in the cost control for improving the Organizations efficiency.


  • This article describes in detail about the necessity for fund raising in India and it describes in detail how to identify the funding agencies, the ways to approach to get funds from them to meet the goal of vision also and thereby increasing quality eye care.



Cost containment is a continuous organizational process. A narrow and too simple approach will not necessarily be of benefit. It is a complex interaction of technical, organisational and human factors, which needs committed leadership, good attitudes of staff and a system approach. Higher expenses per surgery do not necessarily mean higher quality. Hospitals that provide quality service, and in large volume relative to their size, tend to have lower unit costs through better systems. On the whole, cost containment should be viewed as one of the strategies to enhance efficiency in eye care delivery.


Eye hospitals committed to serving the community must understand the reality of cost escalation due to inflation, advancements in medical technology and changing expectations of staff and patients. However, these costs are often not matched by the patients paying capacity. While increasing income, through increased user fees or donations which are financial options that will be considered, this article will focus on cost containment.


Eye care system is at risk due to increasing demand, spiraling costs, inconsistent and poor quality of care, and inefficient, poorly coordinated care systems. Some evidence suggests that health information technology (HIT) can improve the efficiency, cost effectiveness, quality, and safety of medical care delivery by making best practice guidelines and evidence databases immediately available to clinicians, and by making computerized patient records available throughout a health care network.


After Hammurabi conquered Babylonia during the eighteenth century B.C., he formulated his famous code of laws, basing it largely on older Sumerian codes. The code was engraved on a large upright stone, which was set in front of one of the major temples, where it could be seen by the public. Hammurabis code contained a number of sections relating to the eye. Some specified the penalties for causing the loss of an eye. These penalties varied with the nature of the crime and the economic status of the parties involved. One of the most severe penalties called for the destruction of the eye of the accused, a penalty consonant with the phrase that most people associate with Hammurabis laws: An eye for an eye, a tooth for a tooth. In other instances, the payment was as small as one third of a small silver coin (maneh).

Hammurabis code also specified the fees that could be charged for treating eye diseases and injuries, as well as the penalties for medical malpractice. Some of these sections read:
  • The doctor who treats and cures a gentlemens would, or has operated on the eye with a copper lancet, shall charge 10 shekels of silver.
  • If the patient be a poor man, the doctor shall charge 5 shekels of silver.
  • If a doctor operates on a would with a copper lancet, and the patient dies, or on the eye of a gentleman, who loses his eye in consequence, his hands shall be cut off.
Reference : Google Books


Kevin Frick, a health economist and Associate Professor at the Johns Hopkins Bloomberg School of Public Health in the Department of Health Policy and Management, led the cost analysis for Hospital at Home. This involved making early decisions on what cost data to obtain from the sites participating in the national demonstration and planning and carrying out an analysis that presented data common to all of the study sites. He is developing an interactive spread sheet to be used by those interested in adopting Hospital at Home, to estimate the costs and savings in their institution.

Dr. Frick has worked in a wide variety of areas of public health including US community-based public health interventions, international eye disease, and pharmaco-economic analyses. His collaborations within Johns Hopkins University have gained him joint appointments in Economics, Ophthalmology, International Health, and Nursing. He has a great interest in the communication and teaching of health economic concepts, and he has presented at conferences in nursing and ophthalmology and guest lectured all around the campus at Johns Hopkins. He is first author on over 20 peer-reviewed papers that have been published or are forthcoming in the public health or economics literature and a coauthor on over 40 others.




As the number of older adults with acute health needs grows, hospitals need more innovative and cost effective ways to treat these patients. Hospital at Home provides safe, high-quality, hospital-level care to older adults in the comfort of their own homes.

Developed by the Johns Hopkins School of Medicine and tested at medical centers across the country, this innovative care model reduces complications, is highly rated by patients and caregivers, diminishes caregiver stress, and lowers health care costs by nearly one-third.


You can also refer your friends to register with the innovative resources. Send in your friend's e-mail id to us at eyesite@aravind.org with the subject line Register my friend's id!

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Vision 2020 e-resource team,
Lions Aravind Institute of Community Ophthalmology,
1, Annanagar, Madurai - 625 020,
Tamil Nadu, India,
Phone: 91-452-2537580


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