185878 Health Utilty among Community Dwelling Visually Impaired Individuals

Monday, October 27, 2008: 12:45 PM

Kevin D. Frick, PhD , Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Christine Spencer, ScD , School of Public Affairs, University of Baltimore, Baltimore, MD
Emily W. Gower, PhD , Dana Center, Johns Hopkins University, Baltimore, MD
Jennifer L. Wolff, PhD , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
John H. Kempen, MD, MHS, MPH, PhD , Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Philadelphia, PA
     
OBJECTIVES: To determine whether visual impairment and blindness have independent relationships with health utility as measured by a visual analog scale (VAS) or if the relationship is mediated by specific health domains. METHODS: Between 2000 and 2003, Medical Expenditure Panel Survey respondents aged 18 and older were asked the EuroQOL (EQ-5D) questions, including the VAS. Respondents also were asked to report visual impairment or blindness. The analysis included only those aged 40 and over due to the low prevalence of blindness at younger ages. Regression analyses assessed the relationship between visual impairment and the VAS, visual impairment and the five EQ-5D domains, the domains and the VAS response, and the change in the relationship between visual impairment and the VAS when controlling for the domains. RESULTS: Blindness and visual impairment were significantly related to the VAS response when controlling for demographics (B=-5.20, SE=1.32, p=0.0001 and B=-4.64, SE=0.33, p<0.0001 respectively). Visual impairment and blindness were significantly related to each EQ-5D domain (mobility, pain, usual activities, self-care, and anxiety). Each EQ-5D domain was significantly related to the VAS response. When controlling for domains, the relationship between blindness and VAS was completely mediated (B=-0.39, SE=1.00, p=0.70) while the visual impairment relationship was partially mediated (B=-1.77, SE=0.28, p<0.0001). CONCLUSION: While there may be a large health utility upon incident visual impairment, those living with the condition over time may adapt to the condition and have a relatively small loss of utility due to the visual impairment itself rather than the effects of visual impairment.

Learning Objectives:
At the conclusion of this session, attendees will be able to: (1) Describe the concept of health utility (2) Describe the advantages of using the Medical Expenditure Panel Survey to compare those with vision impairment to those who are not visually impaired (3) Articulate the reason that the utility loss found in this study is lower than the utility loss generally associated with visual impairment and blindness that has been reported elsewhere in the literature

Keywords: Quality of Life, Vision Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an associate professor in the Johns Hopkins Bloomberg School of Public Health who has worked extensively with the Medical Expenditure Panel Survey data set and with many studies on visual impairment.
Any relevant financial relationships? No

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.

See more of: Disability and Measurement
See more of: Disability