School of Medicine, University of Michigan, Ann Arbor.
Center for Eye Policy & Innovation, Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor.
JAMA Ophthalmol. 2018 Sep 1;136(9):1047-1050. doi: 10.1001/jamaophthalmol.2018.2524.
Medicare benefits do not include coverage for eyeglasses except after cataract surgery. Understanding the implications of a change to this policy would require knowing the number of Medicare beneficiaries who use eyeglasses, but no recent estimates are available.
To estimate the number of older adults with Medicare who use eyeglasses.
DESIGN, SETTING, PARTICIPANTS: This cross-sectional study used data from the 2015 US National Health and Aging Trends Study. Nationally representative data from 7497 respondents were reviewed and sample weights were applied so that the data represented 43.9 million Medicare beneficiaries aged 65 years or older. The estimates were based on the following 4 groupings of beneficiaries: (1) number who used eyeglasses for distance vision correction and had distance vision impairment, (2) number who did not use eyeglasses for distance vision correction and had distance vision impairment, (3) number who used eyeglasses for near vision correction and had near vision impairment, and (4) number who did not use eyeglasses for near vision correction and had near vision impairment. The prevalence of self-reported use of glasses was estimated using the results of this survey and the Medicare enrollment file. Data were analyzed from July 12, 2017, to November 30, 2017.
Self-reported use of eyeglasses or contact lenses.
Of the estimated 43.9 million Medicare beneficiaries aged 65 years or older in 2015, approximately 40.5 million (92.4%; 95% CI, 91.6%-93.1%) reported using eyeglasses for either distance or near vision correction. Differences in sociodemographics were observed between those who reported using eyeglasses. Individuals who were older, were nonwhite, had lower educational levels, were less affluent, and had prior cataract surgery were significantly less likely to use eyeglasses. Approximately 27 million beneficiaries (61.7%; 95% CI, 60.3%-63.1%) used eyeglasses for distance vision correction, and approximately 37.2 million beneficiaries (84.8%; 95% CI, 83.8%-85.8%) used eyeglasses for near vision correction.
Potential sociodemographic disparities in eyeglass use by age, race/ethnicity, educational level, and income were identified. This finding suggests that innovative public policy solutions are needed to address these disparities among the large number of Medicare beneficiaries who use eyeglasses.
除白内障手术后外，医疗保险福利不包括眼镜的覆盖范围。要了解这项政策变更的影响，需要知道使用眼镜的医疗保险受益人的数量，但目前没有最新的估计数。
估计使用眼镜的老年医疗保险受益人的数量。
设计、地点、参与者：这项横断面研究使用了 2015 年美国国家健康老龄化趋势研究的数据。对来自 7497 名受访者的全国代表性数据进行了审查，并应用了样本权重，以使数据代表 4390 万 65 岁或以上的医疗保险受益人。这些估计数基于以下 4 组受益人的分类：（1）使用眼镜矫正远视力且远视力受损的人数，（2）不使用眼镜矫正远视力且远视力受损的人数，（3）使用眼镜矫正近视力且近视力受损的人数，以及（4）不使用眼镜矫正近视力且近视力受损的人数。使用该调查和医疗保险登记文件的结果估计了自我报告的眼镜使用情况的患病率。数据于 2017 年 7 月 12 日至 2017 年 11 月 30 日进行分析。
自我报告使用眼镜或隐形眼镜。
在 2015 年估计的 4390 万 65 岁或以上的医疗保险受益人中，约有 4050 万人（92.4%；95%CI，91.6%-93.1%）报告说，他们使用眼镜来矫正远或近视力。在报告使用眼镜的人群中观察到社会人口统计学方面的差异。年龄较大、非白人、受教育程度较低、较贫困和以前接受过白内障手术的人使用眼镜的可能性显著降低。约有 2700 万受益人（61.7%；95%CI，60.3%-63.1%）使用眼镜矫正远视力，约有 3720 万受益人（84.8%；95%CI，83.8%-85.8%）使用眼镜矫正近视力。
确定了年龄、种族/族裔、教育程度和收入方面在眼镜使用方面的潜在社会人口统计学差异。这一发现表明，需要创新的公共政策解决方案来解决大量使用眼镜的医疗保险受益人的这些差异。
