title: The economic burden of major adult visual disorders in the United States.
abstract: OBJECTIVE
  To estimate the societal economic burden and the governmental budgetary impact of the following visual disorders among US adults aged 40 years and older: visual impairment, blindness, refractive error, age-related macular degeneration, cataracts, diabetic retinopathy, and primary open-angle glaucoma.
  
  
  METHODS
  We estimated 3 components of economic burden: direct medical costs, other direct costs, and productivity losses. We used private insurance and Medicare claims data to estimate direct medical costs; epidemiologic evidence from multiple published sources to estimate other direct costs, such as nursing home costs; and data from the Survey of Income and Program Participation to estimate productivity losses. We used budgetary documents and our direct medical and other direct cost estimates to approximate the governmental budgetary impact.
  
  
  RESULTS
  We estimated that the annual total financial burden of major adult visual disorders is $35.4 billion ($16.2 billion in direct medical costs, $11.1 billion in other direct costs, and $8 billion in productivity losses) and that the annual governmental budgetary impact is $13.7 billion.
  
  
  CONCLUSIONS
  Major visual disorders among Americans older than 40 years result in substantial economic costs for the US economy. Well-designed public health programs may have the ability to reduce this burden in the future.
authors.affiliation: RTI International, Research Triangle Park, NC, USA. drein@rti.org
authors.forename: David B
authors.initials: DB
authors.lastname: Rein
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Wirth
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lee
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Hoerger
authors.forename: Nancy
authors.initials: N
authors.lastname: McCall
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: James M
authors.initials: JM
authors.lastname: Tielsch
authors.forename: Sandeep
authors.initials: S
authors.lastname: Vijan
authors.forename: Jinan
authors.initials: J
authors.lastname: Saaddine
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics; D004180:Direct Service Costs / Q000706:statistics & numerical data; D004526:Efficiency; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014786:Vision Disorders / Q000191:economics*; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*