Impact of vision loss on costs and outcomes in medicare beneficiaries with glaucoma.
OBJECTIVE
To assess the impact of vision loss severity on costs and health outcomes among Medicare beneficiaries with glaucoma.


METHODS
A retrospective cohort analysis was conducted using Medicare claims. Patients were stratified into 4 categories: no vision loss, moderate vision loss, severe vision loss, and blindness. Outcomes of interest were mean annual medical costs by category, component costs, and frequency of depression, falls and/or accidents, injury, femur fracture, and nursing home placement.


RESULTS
Multivariate regression analysis showed that patients with any degree of vision loss had 46.7% higher total costs compared with patients without vision loss. Mean total and component costs increased with onset and severity ($8157 for no vision loss to $18,670 for blindness). Patients with vision loss were significantly more likely to be placed in a nursing home (odds ratio = 2.18; 95% confidence interval, 2.06-2.31), develop depression (odds ratio = 1.63; 95% confidence interval, 1.54-1.73), fracture a femur (odds ratio = 1.67; 95% confidence interval, 1.53-2.83), or experience a fall or accident (odds ratio = 1.59; 95% confidence interval, 1.50-1.68) vs patients without vision loss.


CONCLUSIONS
Vision loss in glaucoma is costly, and costs increase with severity. There is significantly increased risk of nursing home admission, depression, falls and/or accidents, injury, or femur fracture with vision loss compared with no vision loss.
Bramley
Thomas
T
Xcenda, Salt Lake City, Utah 84108, USA. thomas.bramley@xcenda.com
Peeples
Patti
P
Walt
John G
JG
Juhasz
Marta
M
Hansen
Jan E
JE
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003863:Depression / Q000209:etiology; D005260:Female; D005264:Femoral Fractures / Q000209:etiology; D005901:Glaucoma / Q000150:complications* / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D007326:Institutionalization; D008297:Male; D006278:Medicare; D009735:Nursing Homes; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014481:United States; D014786:Vision Disorders / Q000150:complications / Q000191:economics* / Q000209:etiology / Q000503:physiopathology*