160073 Visual Impairment Monetary Dependency Ratios over Time

Tuesday, November 6, 2007: 9:30 AM

Kevin D. Frick, PhD , Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Christine Spencer, ScD , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Jennifer L. Wolff, PhD , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Emily W. Gower, PhD , Dana Center, Johns Hopkins University, Baltimore, MD
John H. Kempen, MD, MHS, MPH, PhD , Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Philadelphia, PA
        
Objective: We define the “visual impairment monetary dependency ratio” as the ratio of the dollar value of excess informal care received and excess medical care utilized by individuals aged 40 and older with visual impairment to the number of individuals aged 18-65, i.e. those most likely working and paying income taxes that fund public services. We present this ratio for the United States in 2004 and 2030 and describe interstate variation.

Methods: Data on individuals aged 40 and older in the 1996-2004 Medical Expenditure Panel Survey data were analyzed (N=103,428). All dollar figures were adjusted to 2004. The excess informal care received by and medical care expenditures among individuals with visual impairment compared with those with no visual impairment were estimated using multivariable regressions controlling for potential demographic and comorbidity confounders. Excess informal care was converted into dollars using the national minimum wage, $5.15 per hour. National projections were made using published age-specific prevalence rates and US Census Bureau population projections.

Results: The visual impairment monetary dependency ratio was $30 in 2004 and is projected to rise to $48 in 2030. State-specific ratios in 2004 varied by a factor of 3. In 2030, state-specific ratios vary from $32 (Washington, DC) to $71 (New Mexico).

Conclusion: The visual impairment monetary dependency ratio is predicted to increase by 60% by 2030. The burden on taxpayers and family members of individuals with visual impairments will increase substantially unless the age-specific prevalence of visual impairment or excess informal and medical care costs is decreased.

Learning Objectives:
1. To define the visual impairment monetary dependency ratio 2. To describe the ratio from 2004 to 2030 in the United States as a whole and among states 3. To analyze what changes in prevalence or individual burden would need to occur to keep the dependency ratio constant

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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