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

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.