IMPACT OF NEW ELIGIBILITY CRITERIA ON A SCREENING PROGRAM FOR RETINOPATHY OF PREMATURITY. ONE-YEAR EVALUATION

OBJECTIVE: To evaluate, in clinical and economical terms, a screening program for retinopathy of prematurity 1 year after implementing new eligibility criteria. METHOD: New criteria to safely reduce the number of newborn infants screened without missing any stage 3 retinopathies of prematurity were established after reviewing the clinical information from the 1991-1998 screening program. In 1999 the infants were screened according to the new eligibility criteria. The absolute and relative reduction in the number of patients requiring screening was determined by comparing the implementation of the new eligibility criteria with the previous criteria. Criteria 1991-1998: a) Birth weight 1,500 g or gestational age 33 weeks; and b) gestational age 34-36 weeks with exposure to supplemental oxygen for at least 24 h. New criteria 1999: a) Birth weight 1,250 g or gestational age 30 weeks; and b) infants with birth weight > 1,250 g or gestational age > 30 weeks with very serious neonatal medical problems according to the neonatologist. RESULTS: In 1999, 244 patients would have been screened with the 1991-1998 criteria. Applying the new 1999 criteria, only 72 patients were screened. The number of examinations saved was 369 and the cost of the program decreased by 30,000 euros. CONCLUSIONS: The new eligibility criteria for retinopathy of prematurity screening has reduced the number of patients screened by 70 %. To ensure inclusion of all newborn infants at risk of developing the disease and to minimize the number of screened infants and cost of the program, screening strategies can be tailored to health centers' specific characteristics.