Department of Public Health Research, NORC at the University of Chicago, Morrisville, North Carolina 27560, USA.
Ophthalmology. 2013 Sep;120(9):1728-35. doi: 10.1016/j.ophtha.2013.01.068. Epub 2013 Apr 28.
To estimate the economic burden of vision loss and eye disorders in the United States population younger than 40 years in 2012.
Econometric and statistical analysis of survey, commercial claims, and census data.
The United States population younger than 40 years in 2012.
We categorized costs based on consensus guidelines. We estimated medical costs attributable to diagnosed eye-related disorders, undiagnosed vision loss, and medical vision aids using Medical Expenditure Panel Survey and MarketScan data. The prevalence of vision impairment and blindness were estimated using National Health and Nutrition Examination Survey data. We estimated costs from lost productivity using Survey of Income and Program Participation. We estimated costs of informal care, low vision aids, special education, school screening, government spending, and transfer payments based on published estimates and federal budgets. We estimated quality-adjusted life years (QALYs) lost based on published utility values.
Costs and QALYs lost in 2012.
The economic burden of vision loss and eye disorders among the United States population younger than 40 years was $27.5 billion in 2012 (95% confidence interval, $21.5-$37.2 billion), including $5.9 billion for children and $21.6 billion for adults 18 to 39 years of age. Direct costs were $14.5 billion, including $7.3 billion in medical costs for diagnosed disorders, $4.9 billion in refraction correction, $0.5 billion in medical costs for undiagnosed vision loss, and $1.8 billion in other direct costs. Indirect costs were $13 billion, primarily because of $12.2 billion in productivity losses. In addition, vision loss cost society 215 000 QALYs.
We found a substantial burden resulting from vision loss and eye disorders in the United States population younger than 40 years, a population excluded from previous studies. Monetizing quality-of-life losses at $50 000 per QALY would add $10.8 billion in additional costs, indicating a total economic burden of $38.2 billion. Relative to previously reported estimates for the population 40 years of age and older, more than one third of the total cost of vision loss and eye disorders may be incurred by persons younger than 40 years.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
估计 2012 年美国 40 岁以下人群视力丧失和眼部疾病的经济负担。
对调查、商业索赔和人口普查数据进行计量经济学和统计分析。
2012 年美国 40 岁以下人群。
我们根据共识指南对成本进行分类。我们使用医疗支出面板调查和市场扫描数据,估计了与已诊断眼部疾病相关的医疗费用、未确诊的视力丧失和医疗视力辅助设备的费用。使用国家健康和营养检查调查数据估计视力障碍和失明的患病率。我们使用收入和项目参与调查估计了因生产力下降而造成的损失。我们根据已发表的估计数和联邦预算,估计了非正式护理、低视力辅助器具、特殊教育、学校筛查、政府支出和转移支付的费用。我们根据已发表的效用值估计了丧失的质量调整生命年(QALY)。
2012 年的损失成本和 QALY。
2012 年,美国 40 岁以下人群的视力丧失和眼部疾病的经济负担为 275 亿美元(95%置信区间,215 亿-372 亿美元),其中 59 亿美元用于儿童,216 亿美元用于 18 至 39 岁的成年人。直接费用为 145 亿美元,包括 73 亿美元用于已诊断疾病的医疗费用、49 亿美元用于屈光度矫正、5 亿美元用于未确诊视力丧失的医疗费用和 18 亿美元用于其他直接费用。间接费用为 130 亿美元,主要是因为生产力损失 122 亿美元。此外,视力丧失使社会损失了 21.5 万个 QALY。
我们发现,与 40 岁以上人群相比,美国 40 岁以下人群的视力丧失和眼部疾病造成了相当大的负担,而这一人群在以前的研究中被排除在外。将生命质量损失的货币化价值定为 5 万美元/QALY 将使额外成本增加 108 亿美元,表明经济总负担为 382 亿美元。与以前报告的 40 岁及以上人群的估计数相比,视力丧失和眼部疾病的总成本中,40 岁以下人群的负担可能超过三分之一。
作者没有与本文讨论的任何材料有关的专利或商业利益。