OBJECTIVE: To assess the impact of vision loss severity on costs and health outcomes among Medicare beneficiaries with glaucoma. METHODS: A retrospective cohort analysis was conducted using Medicare claims. Patients were stratified into 4 categories: no vision loss, moderate vision loss, severe vision loss, and blindness. Outcomes of interest were mean annual medical costs by category, component costs, and frequency of depression, falls and/or accidents, injury, femur fracture, and nursing home placement. RESULTS: Multivariate regression analysis showed that patients with any degree of vision loss had 46.7% higher total costs compared with patients without vision loss. Mean total and component costs increased with onset and severity ($8157 for no vision loss to $18,670 for blindness). Patients with vision loss were significantly more likely to be placed in a nursing home (odds ratio = 2.18; 95% confidence interval, 2.06-2.31), develop depression (odds ratio = 1.63; 95% confidence interval, 1.54-1.73), fracture a femur (odds ratio = 1.67; 95% confidence interval, 1.53-2.83), or experience a fall or accident (odds ratio = 1.59; 95% confidence interval, 1.50-1.68) vs patients without vision loss. CONCLUSIONS: Vision loss in glaucoma is costly, and costs increase with severity. There is significantly increased risk of nursing home admission, depression, falls and/or accidents, injury, or femur fracture with vision loss compared with no vision loss.
OBJECTIVE: To assess the impact of vision loss severity on costs and health outcomes among Medicare beneficiaries with glaucoma. METHODS: A retrospective cohort analysis was conducted using Medicare claims. Patients were stratified into 4 categories: no vision loss, moderate vision loss, severe vision loss, and blindness. Outcomes of interest were mean annual medical costs by category, component costs, and frequency of depression, falls and/or accidents, injury, femur fracture, and nursing home placement. RESULTS: Multivariate regression analysis showed that patients with any degree of vision loss had 46.7% higher total costs compared with patients without vision loss. Mean total and component costs increased with onset and severity ($8157 for no vision loss to $18,670 for blindness). Patients with vision loss were significantly more likely to be placed in a nursing home (odds ratio = 2.18; 95% confidence interval, 2.06-2.31), develop depression (odds ratio = 1.63; 95% confidence interval, 1.54-1.73), fracture a femur (odds ratio = 1.67; 95% confidence interval, 1.53-2.83), or experience a fall or accident (odds ratio = 1.59; 95% confidence interval, 1.50-1.68) vs patients without vision loss. CONCLUSIONS:Vision loss in glaucoma is costly, and costs increase with severity. There is significantly increased risk of nursing home admission, depression, falls and/or accidents, injury, or femur fracture with vision loss compared with no vision loss.
Authors: G Vandewalle; S Schwartz; D Grandjean; C Wuillaume; E Balteau; C Degueldre; M Schabus; C Phillips; A Luxen; D J Dijk; P Maquet Journal: Proc Natl Acad Sci U S A Date: 2010-10-25 Impact factor: 11.205
Authors: Joshua D Stein; Leslie M Niziol; David C Musch; Paul P Lee; Sameer V Kotak; Colleen M Peters; Steven M Kymes Journal: Am J Ophthalmol Date: 2012-07-11 Impact factor: 5.258
Authors: Xinzhi Zhang; Kai McKeever Bullard; Mary Frances Cotch; M Roy Wilson; Barry W Rovner; Gerald McGwin; Cynthia Owsley; Lawrence Barker; John E Crews; Jinan B Saaddine Journal: JAMA Ophthalmol Date: 2013-05 Impact factor: 7.389