Cost-Effectiveness of a Telemedicine Optometric-Based Assessment for Screening Diabetic Retinopathy in a Country with a Universal Public Health System.

To determine the cost-effectiveness of a new telemedicine optometric-based screening program of diabetic retinopathy (DR) compared with traditional models' assessments in a universal European public health system. A new teleophthalmology program for DR based on the assessment of retinographies (3-field Joslin Vision Network by a certified optometrist and a reading center [IOBA-RC]) was designed. This program was first conducted in a rural area 40 km from the referral hospital (Medina de Rioseco, Valladolid, Spain).

[Palliative and support care at home in primary care].

Objectives: To estimate the proportion of people requiring palliative and support care at home in primary care and to describe their characteristics.

Methods: A descriptive study was carried out by five Spanish sentinel networks between October 2007 and March 2008 in 282,216 people attended by 218 general practitioners and nurses. Patients receiving comprehensive, active and continued care at home were included if the aim was not to prolong life but to achieve the best quality of life for the patient, the family and the carers.