School Screening Cost

Identification of School Screening Programs

Naser and Hartman conducted a survey identifying the ages at which preschool and school-based vision screening is conducted in each state.[23] The authors identified school screening programs in 46 states and the District of Columbia, with screening occurring in nearly five grade levels on average per state with school screening. Naser and Hartman identified 15 states with preschool screening, and we have identified an additional 3 states for a total of 18 states with preschool screening. We assume that preschool screening programs target only 3-year-olds.

Screening Costs and Uptake

Table 7.1. Preschool Screening Costs, by State

Preschool Screening Costs, by State

Table 7.2. School Screening Costs, by State

School Screening Costs, by State

We based per student preschool screening costs on the program and volunteer labor costs incurred by Prevent Blindness Georgia (PBGA).[24] PBGA conducts symbol acuity and stereopsis tests on all 3-year-olds enrolled in state-funded preschools. Contract costs for PBGA were $6.49 per child screened. About 10% of screens were conducted by volunteers, typically preschool teachers or administrators. We assigned costs for volunteer labor based on the average per capita hourly wage and the time per child screened as estimated by PBGA staff.[25] Including these costs, we estimate the total economic cost of screening to be $6.72 per child screened in 2008. Because Georgia’s state-funded preschool program is unique, we based preschool screening penetration on the rates achieved by North Carolina’s Prevent Blindness Screening Program, which reaches approximately 44% of state residents in the targeted age group per year. We do not base costs on the North Carolina program because it uses a unique and relatively costly universal photoscreening program that costs $17 per child.

We estimate the cost of school-based vision screening to be $4.15 per child screened, which is the average estimated program and volunteer labor cost per child screened observed in North Carolina and Virginia. Both programs report near universal screening compliance for targeted age groups, and therefore we assume that 100% of residents at each targeted age level in school screening programs will receive a screen.

Tables 7.1 and 7.2 show the total per state costs for preschool and school vision screening, respectively. Costs were updated to 2013 levels based on the Consumer Price Index.