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Geographical distribution of macular disease among elderly Medicare beneficiaries in Kansas

Carol Ann Holcomb, PhD, CHES, Department of Human Nutrition, Kansas State University, 210 Justin Hall, Manhattan, KS 66506-1407, 785-532-5508, carolann@ksu.edu

Macular disease is the leading cause of low vision in older adults. Medicare data have been used to map several diseases and conditions, but no studies have been published of macular disease. The study population in Kansas was constructed by identifying Part B claims in 1999 with an ICD-9 code of 362.50 to 362.57. Medicare enrollment data for 1999 constituted the denominator. Cases and beneficiaries were stratified by county, age, gender, and race. Maps were produced with EpiMap 2002 (CDC, Atlanta, GA). During the study period, a total of 17,888 unduplicated claims for macular disease were identified from 335,132 beneficiaries. Age-adjusted prevalence was calculated using the direct method. The state prevalence was 5.3% and varied by county from a low of 2.1% to a high 11.5%. Counties with the highest prevalence were clustered in a north-south gradient in the central area of the state. Increased prevalence by age group was consistent in 97 of the 105 counties. In 95 counties women had a higher prevalence of claims compared to men. Sparse data for nonwhites at the county level precluded comparisons by race. However, at the state level the prevalence for whites (5.5%) was only slightly higher than the prevalence for all races combined (5.3%), but it was 2.5 times the prevalence for nonwhites (2.2%). These data are consistent with results from some, but not all, previously reported epidemiological studies of smaller catchment areas showing age, female gender, and white race as risk factors for macular disease.

Learning Objectives:

Keywords: Medicare,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Innovations in Long-term Care

The 132nd Annual Meeting (November 6-10, 2004) of APHA