270656 Excess Expenditures, Excess Informal Care Days, and Quality of Life Decrements Associated with Self-Reported Visual Impairment and Blindness

Tuesday, October 30, 2012 : 10:30 AM - 10:50 AM

Kevin D. Frick, PhD , Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Lori L. Grover, OD , Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
Elizabeth Wehler , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Purpose: To update a previous estimate of the increases in medical care expenditures and informal care days, and the decrement in health related quality of life associated with self-reported visual impairment (problems reading newsprint and/or seeing faces even with correction) and blindness.

Methods: Data from the Medical Expenditure Panel Survey in the United States (2003-2008) were merged. The analytic data file included those aged 40+ with no missing data on total health care expenditures or confounders. Multivariable linear regressions were run to assess the association between vision impairment, expenditures, informal care days, and quality of life controlling for confounders. All regressions were weighted and accounted for the complex study design. Expenditures were adjusted to 2011 dollars using the medical care consumer price index before analysis.

Results: After controlling for potential confounders, blindness was still associated with $2122 excess expenditures [95% CI 192, 4051] and impairment was associated with $864 excess expenditures [95% CI 405, 1322]. Only impairment was statistically significantly associated with greater care days (1.3, 95% CI 0.63, 2.0). On the SF-36 PCS, impairment was associated with a 2.0 unit decrement [95% CI -2.3, -1.7] and blindness was associated with a 2.9 unit decrement [95% CI -4.1, -1.7]. For the SF-36 MCS, both impairment (-2.6, 95% CI -2.9, -2.2) and blindness (-2.5, 95% CI -4.4, -0.61) were associated with decrements.

Conclusions: Blindness and self-reported visual impairment are associated with excess medical care expenditures, excess days of informal care, and decrements to quality of life.

Learning Areas:
Administration, management, leadership
Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice
Program planning

Learning Objectives:
(1) Define the different aspects of the economic burden of vision impairment and blindness (2) Describe the magnitude of the burden of vision impairment and blindness at the individual and society level

Keywords: Vision Care, Economic Analysis

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a federally funded researcher, health economist, and author of a paper published in Archives of Ophthalmology that this presentation is an update for.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Center for Applied Value Analysis Retinitis pigmentosa Consultant

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.