Frick Kevin D, Gower Emily W, Kempen John H, Wolff Jennifer L
Department of Health Policy and Management, Health Services Research and Development Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205-1901, USA.
Arch Ophthalmol. 2007 Apr;125(4):544-50. doi: 10.1001/archopht.125.4.544.
To assess the economic impact of excess medical and informal care and the health utility loss associated with visual impairment and blindness in adults aged 40 years and older in the United States.
Medical Expenditure Panel Survey data from 1996 to 2002 were pooled to estimate the relationship of visual impairment and blindness with total medical expenditures, components of expenditures, days of informal care received, and health utility. Estimates accounting for the complex sampling design were based on regressions including confounders such as comorbidities and demographics. The aggregate economic impact was estimated by projecting average individual effects to the population of individuals with blindness and visual impairment.
Blindness and visual impairment were significantly associated with higher medical care expenditures, a greater number of informal care days, and a decrease in health utility. The home care component of expenditures was most affected by blindness. The aggregate annual economic impact included $5.5 billion spent for medical care and the value of informal care as well as a loss of more than 209,000 quality-adjusted life years.
Visual impairment has a large effect on home care. Any economic analysis of prevention, treatment, and rehabilitation should account for the fraction of the annual monetary cost and loss of quality-adjusted life years that can be averted.
评估美国40岁及以上成年人中,过度医疗和非正式护理所产生的经济影响,以及与视力障碍和失明相关的健康效用损失。
汇总1996年至2002年的医疗支出面板调查数据,以估计视力障碍和失明与总医疗支出、支出构成、接受非正式护理的天数以及健康效用之间的关系。考虑到复杂抽样设计的估计是基于包含合并症和人口统计学等混杂因素的回归分析。通过将个体平均效应推算至失明和视力障碍人群,估计总体经济影响。
失明和视力障碍与更高的医疗护理支出、更多的非正式护理天数以及健康效用下降显著相关。支出中的家庭护理部分受失明影响最大。总体年度经济影响包括55亿美元的医疗护理支出和非正式护理价值,以及超过20.9万个质量调整生命年的损失。
视力障碍对家庭护理有很大影响。任何关于预防、治疗和康复的经济分析都应考虑到每年可避免的货币成本和质量调整生命年损失的比例。