title: Recent trends in upper eyelid blepharoplasties in medicare patients in the United States from 1995 to 1999.
abstract: OBJECTIVE
  To present data regarding the rate of upper eyelid blepharoplasty in the Medicare population at both the national and the regional levels from 1995 to 1999 and to analyze these data for any correlation with reimbursement, surgical criteria differences, or the number of ophthalmologists per capita.
  
  
  METHODS
  This was a retrospective cohort study. The subjects consisted of a 5% random sample of the Medicare population who had blepharoplasty from 1995 to 1999. Number, rate, and reimbursements of blepharoplasty of the 10 Health Care Financing Administration (HCFA) regions were compared for the 5-year period. Number of ophthalmologists per capita and differences in the regional criteria for Medicare-approved upper eyelid blepharoplasty were compared among the 10 HCFA regions.
  
  
  RESULTS
  Across the nation, there was a 13% annual increase in the rate of blepharoplasty from 1995 to 1999 in the Medicare-population after adjusting for age, race, sex, and HCFA regions. During the same period, the average reimbursement per surgery decreased by $26.50 annually. There was a statistically significant inverse correlation between reimbursement and rate of blepharoplasty at the national level (r= - 0.74, P< 0.001). On the regional level, this relation was less profound (r= -0.29, P= 0.039). There was no correlation between the rate of blepharoplasty and the number of ophthalmologists per capita or the differences in surgical criteria.
  
  
  CONCLUSIONS
  The inverse relation between rate of Medicare-approved blepharoplasty and reimbursement between 1995 and 1999 was evident at both the national and regional levels. No relation between regional differences in the rates of blepharoplasty and regional differences in surgical criteria or the number of ophthalmologists per capita were identified. Though our study suggests no causal link between annual rate of blepharoplasty and Medicare reimbursement, such inverse correlation is interesting and may have been affected by other factors such as changing clinical indications for this procedure.
authors.affiliation: UCSF School of Medicine, San Francisco, California, USA.
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Golchet
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Robert
authors.initials: R
authors.lastname: Goldberg
authors.forename: Anne L
authors.initials: AL
authors.lastname: Coleman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty / Q000706:statistics & numerical data / Q000639:trends*; D014487:Centers for Medicare and Medicaid Services, U.S.; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D016345:Medicare Part B; D012189:Retrospective Studies; D014481:United States