Costs of refractive correction of distance vision impairment in the United States, 1999-2002.
OBJECTIVE
Correctable vision impairment caused by refractive error is common in the United States population. We estimated the direct costs of providing eyeglasses to all Americans (age> or =12) who need refractive correction to achieve good distance vision.


METHODS
Cross-sectional study of a nationally representative sample of United States citizens.


METHODS
Participants in the 1999-2002 National Health and Nutrition Examination Survey (NHANES), age > or = 12 years. The NHANES examines a nationally representative sample of the U.S. noninstitutionalized, civilian population.


METHODS
Presenting and corrected visual acuity data were obtained using an autorefractor from 13,211 (93.0%) of the 14,203 participants who visited the NHANES Mobile Examination Center in 1999 through 2002. Need for refractive correction was defined by current use of corrective lenses for distance vision, improvement to good visual acuity following autorefractor correction (using several cutpoints to define good visual acuity), or both.


METHODS
Estimates of direct cost for refractive correction (1 pair of complete eyeglasses and a refraction examination) were computed based on Centers for Medicare & Medicaid Services fee schedules for 2000 and also based on expenditure data from the Medical Expenditure Panel Survey.


RESULTS
The NHANES results indicate that >110 million Americans could or do achieve normal vision with refractive correction. The annual direct cost of correcting distance vision impairment is at least $3.8 billion. Of this amount, $780 million represents the annual cost of providing distance vision correction for persons > age 65.


CONCLUSIONS
Correctable vision impairment due to refractive error is common in the United States population. These cost estimates provide useful information for public health endeavors aimed at provision of refractive correction to those who need it.
Vitale
Susan
S
Division of Epidemiology and Clinical Research, National Institutes of Health, Bethesda, Maryland 20814-9301, USA. sev@nei.nih.gov
Cotch
Mary Frances
MF
Sperduto
Robert
R
Ellwein
Leon
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004180:Direct Service Costs; D005139:Eyeglasses / Q000191:economics*; D005245:Fee Schedules; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012030:Refractive Errors / Q000150:complications / Q000191:economics*; D014481:United States; D014786:Vision Disorders / Q000191:economics* / Q000209:etiology; D014792:Visual Acuity; D019987:Persons with Visual Disabilities