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首页> 外文期刊>Ophthalmology >Association between vision loss and higher medical care costs in Medicare beneficiaries costs are greater for those with progressive vision loss.
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Association between vision loss and higher medical care costs in Medicare beneficiaries costs are greater for those with progressive vision loss.

机译：对于进行性视力丧失的人，视力下降与医疗保险受益人费用中较高的医疗费用之间的关联更大。

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PURPOSE: To identify the cost to the Medicare program for patients with either stable or progressive vision loss and to estimate the impact on eye-related and non-eye related care. DESIGN: Retrospective cohort study. PARTICIPANTS: The study population was Medicare beneficiaries included in the standard 5% analytic sample and continuously enrolled from 1999 to 2003, excluding Medicare managed-care enrollees. METHODS: Vision loss was categorized as moderate loss, severe loss, and blindness, based on International Classification of Diseases 9, Clinical Modification codes. MAIN OUTCOME MEASURES: Average yearly cost of eye-related and non-eye related medical care during 1999 to 2003, in 2003 dollars. Secondary outcomes: (1) depression, (2) injury, (3) skilled nursing facility (SNF) utilization, and (4) long-term care facility (LTC) admission. RESULTS: Compared with patients with normal vision, excess adjusted mean eye-related costs were 345 dollars, 407 dollars, and 237 dollars annually for those with moderate loss, severe loss, and blindness, respectively; annual excess non-eye related costs were 2193 dollars, 3301 dollars, and 4443 dollars, respectively. At each level of vision loss, those progressing from a presumably normal state at baseline incurred higher Medicare costs than those with that level of vision loss at baseline. Any degree of progressive vision loss was associated with an increased risk of depression, injury, SNF utilization, and LTC admission. Identifiable costs attributable to these complications explained 27% to 41% of the excess costs associated with vision loss. CONCLUSIONS: Medicare beneficiaries with coded diagnoses of vision loss incur significantly higher costs than those with normal vision, and approximately 90% of these costs are non-eye related medical costs. Extrapolating to the entire Medicare population, blindness and vision loss are associated with Dollars 2.14 billion in 2003 non-eye related medical costs. Preventing vision loss is not only a medical imperative but also an economic one.
机译：目的：确定患有稳定或进行性视力丧失的患者的Medicare计划的费用，并估计对与眼有关和与非眼有关的护理的影响。设计：回顾性队列研究。参与者：研究人群为标准5％分析样本中所包括的Medicare受益人，并且从1999年至2003年连续入选，但不包括Medicare管理医疗入选者。方法：根据国际疾病分类9，临床修改规范，视力丧失分为中度丧失，严重丧失和失明。主要观察指标：1999年至2003年，与眼睛有关和与非眼睛有关的医疗保健的平均年度费用，以2003年美元计。次要结果：（1）抑郁，（2）伤害，（3）使用熟练的护理机构（SNF）和（4）长期护理机构（LTC）入院。结果：与视力正常的患者相比，中度失重，重度失明和失明的患者每年调整后的平均眼相关费用分别为345美元，407美元和237美元。每年与非眼睛相关的额外费用分别为2193美元，3301美元和4443美元。在每个视力丧失水平上，那些从大概处于基线状态的正常状态发展的人所产生的医疗保险费用要高于那些在基线时具有那种视力丧失水平的人。任何程度的进行性视力丧失都与抑郁，受伤，SNF利用和LTC入院的风险增加有关。可归因于这些并发症的可识别成本解释了与视力丧失相关的超额成本的27％至41％。结论：具有视力丧失编码诊断的医疗保险受益人的费用要比具有正常视力的受益人高得多，其中大约90％的费用与非眼科医疗费用有关。推断到整个医疗保险人口，失明和视力丧失与2003年与非眼睛相关的医疗费用21.4亿美元相关。预防视力丧失不仅是医学上的必要，而且是经济上的。

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