Ambulatory and hospital care of glaucoma in Spain and associated medical costs

Objectives This study aimed to analyze the impact of glaucoma in ambulatory centers and hospitals in Spain over the past decade, in terms of incidence and medical costs. Methods Administrative data of glaucoma patients from ambulatory centers and hospitals in Spain and registered between 2011 and 2020 was obtained from a Spanish National discharge database. Medical costs obtained were based on the diagnosis-related group-based hospital payment systems, determined by the Spanish Ministry of Health. Results Data from 100,734 ambulatory care visits and 11,408 hospital admissions related to glaucoma were obtained from the database. Most of the cases were registered in patients over 65 years of age. The incidence of glaucoma in ambulatory centers was 2.2 per 10,000 persons over the study period; in hospitals, the incidence was 0.2 per 10,000 persons. The incidence of glaucoma in ambulatory settings increased significantly over the study period, while the incidence in hospitals decreased over the same period. Most ambulatory visits and hospital admissions were programmed or non-urgent. The mean cost per ambulatory visit was euro954, euro5.5 million in total annually; the mean cost per hospital admission was euro3,727, euro4.1 million in total annually. The annual cost of ambulatory care increased significantly over the study period, while the annual cost of hospital care decreased significantly. Conclusions The medical costs of glaucoma in Spanish hospitals decreased over the study period, while the costs of ambulatory care increased. This shift in the management of glaucoma should be considered in future resource allocation decisions.