Bal Sila, Kurichi Jibby E, Kwong Pui L, Xie Dawei, Hennessy Sean, Na Ling, Pezzin Liliana E, Streim Joel E, Bogner Hillary R
a Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.
b Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.
Ophthalmic Epidemiol. 2017 Dec;24(6):364-370. doi: 10.1080/09286586.2017.1296961. Epub 2017 Mar 27.
To examine the association between vision impairment and all-cause hospitalization among elderly Medicare beneficiaries.
A population-based study (N = 22,681) of community-dwelling Medicare beneficiaries aged 65 years and older who participated in the Medicare Current Beneficiary Survey for the years 2001-2007. Beneficiaries were classified into self-reported presence of vision impairment versus no vision impairment. Inpatient hospitalizations were identified using Medicare claims data. A multivariable Cox proportional hazard model examined the association between presence of vision impairment and time to first hospitalization within 3 years of survey entry after adjusting for sociodemographics, comorbidities, hearing impairment, and activity limitation stages derived from difficulty performing the activities of daily living.
Medicare beneficiaries who self-reported the presence of vision impairment were significantly more likely to be hospitalized over 3 years compared to beneficiaries without vision impairment even after adjustment for potentially influential covariates (hazard ratio = 1.14 and 95% confidence interval: 1.05-1.23).
Medicare beneficiaries with self-reported vision impairment were at higher risk of hospitalization during a 3-year period. Further research may identify reasons that are amenable to policy interventions.
研究老年医疗保险受益人群中视力障碍与全因住院之间的关联。
一项基于人群的研究（N = 22,681），研究对象为年龄在65岁及以上、居住在社区的医疗保险受益人，他们参与了2001 - 2007年的医疗保险当前受益人调查。受益人根据自我报告的视力障碍情况分为有视力障碍组和无视力障碍组。利用医疗保险理赔数据确定住院情况。一个多变量Cox比例风险模型在对社会人口统计学、合并症、听力障碍以及从日常生活活动困难程度得出的活动受限阶段进行调整后，研究了视力障碍的存在与调查进入后3年内首次住院时间之间的关联。
自我报告有视力障碍的医疗保险受益人在3年期间住院的可能性显著高于无视力障碍的受益人，即使在对潜在影响协变量进行调整之后（风险比 = 1.14，95%置信区间：1.05 - 1.23）。
自我报告有视力障碍的医疗保险受益人在3年期间住院风险更高。进一步的研究可能会找出适合政策干预的原因。
