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Original ArticleOpen Access
Cost Effectiveness Analysis of a Visual Screening Program for Primary School Children in Thailand
Tengtrisorn S 
,
Sangsupawanitch P ,
Chansawang W
,
Sangsupawanitch P ,
Chansawang W Objective: To analyze the cost-effectiveness of a visual screening program for primary school children in
southern Thailand.
Material and Method: The visual acuity of 1,900 primary school children from 11 schools in southern Thailand
was assessed using the Snellen chart, Hirschberg test, an eye examination by penlight, and observation of
the red reflex by direct ophthalmoscope, between April 2006 and March 2007. Children with visual acuity of
< 20/40 or an abnormal observation in either eye were referred for further eye examination and refraction
measurement, at which time they were categorized, according to the severity of the eye condition(s). A cost
analysis was then performed for various severity-of-condition groupings.
Results: One hundred sixty eight children (8.8%) were found with referable problems, of which 122 parents
signed a consent form for further testing. The mean age was 8.7 years (range 6-12 years). One hundred seven
of the 122 subjects (87.7%) were considered to have a refractive error with or without one or more other
eye conditions. The mean direct cost for visual screening by the assistant researcher, not including project
management and traveling expenses, was 14.9 Baht per student (~0.5 USD, 0.3 Euro). For nationwide
implementation, the per head expenditure for children with treatable problems would be 1,018.4 Baht if
children with mild, moderate and severe abnormal eye conditions were targeted, and increased to 2,270.1
Baht if only children with moderate and severe conditions were targeted.
Conclusion: The results of the present study indicate that this visual screening program is efficient and useful
for preliminary school children in Thailand.
Keywords: Cost analysis, Students, Vision screening
southern Thailand.
Material and Method: The visual acuity of 1,900 primary school children from 11 schools in southern Thailand
was assessed using the Snellen chart, Hirschberg test, an eye examination by penlight, and observation of
the red reflex by direct ophthalmoscope, between April 2006 and March 2007. Children with visual acuity of
< 20/40 or an abnormal observation in either eye were referred for further eye examination and refraction
measurement, at which time they were categorized, according to the severity of the eye condition(s). A cost
analysis was then performed for various severity-of-condition groupings.
Results: One hundred sixty eight children (8.8%) were found with referable problems, of which 122 parents
signed a consent form for further testing. The mean age was 8.7 years (range 6-12 years). One hundred seven
of the 122 subjects (87.7%) were considered to have a refractive error with or without one or more other
eye conditions. The mean direct cost for visual screening by the assistant researcher, not including project
management and traveling expenses, was 14.9 Baht per student (~0.5 USD, 0.3 Euro). For nationwide
implementation, the per head expenditure for children with treatable problems would be 1,018.4 Baht if
children with mild, moderate and severe abnormal eye conditions were targeted, and increased to 2,270.1
Baht if only children with moderate and severe conditions were targeted.
Conclusion: The results of the present study indicate that this visual screening program is efficient and useful
for preliminary school children in Thailand.
Keywords: Cost analysis, Students, Vision screening
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