Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Mil Med. 2023 Nov 3;188(11-12):e3393-e3397. doi: 10.1093/milmed/usad070.
Eye and vision disorders are estimated to impact 7.08 million people in the United States, including 1.62 million under the age of 40. This study uses the Vision and Eye Health Surveillance System (VEHSS) case definitions to assess the burden of eye and vision disorders in a universally insured, nationally representative population.
This retrospective, cross-sectional study applied the VEHSS case definitions to TRICARE claims data collected from the Military Health System Data Repository and Defense Enrollment Eligibility Reporting System during 2018. Beneficiaries aged 0-64 years during the fiscal year 2018 were identified with inpatient and outpatient codes matching to the VEHSS diagnostic case definitions, which were organized into 17 categories of eye and vision disorders classified by the ICD-10. Beneficiaries were recorded only once per category but allowed to match to multiple categories. Analyses included descriptive statistics of patient demographics and prevalence of eye disorders.
We identified 4,548,897 TRICARE Prime/Plus beneficiaries (54.86% men and 45.14% women), of whom 22.93% were diagnosed with at least one disorder in 2018. Of those with a diagnosis, the majority were men (50.13%), adults (74.91%), and of or sponsored by a senior enlisted rank (57.83%), used as socioeconomic proxy. Disorders of refraction and accommodation were most prevalent, followed by infectious and inflammatory diseases. Potentially preventable and treatable conditions, including amblyopia and strabismus, infectious and inflammatory disease, and diabetic complications, affected up to 22% of those with vision disorders.
This study represents the first use of VEHSS measures in a universally insured, socioeconomically diverse population. Identification of potentially treatable or preventable conditions indicates significant opportunity to mitigate the burden of eye and vision disorders in the Military Health System.
据估计，美国有 708 万人患有眼部和视力障碍，其中 162 万人年龄在 40 岁以下。本研究使用视力和眼部健康监测系统（VEHSS）的病例定义，评估普遍参保、具有代表性的全国人群中眼部和视力障碍的负担。
这是一项回顾性、横断面研究，将 VEHSS 病例定义应用于 2018 年从军事医疗系统数据存储库和国防登记入选报告系统收集的 TRICARE 索赔数据。在 2018 财年，确定年龄在 0-64 岁的医疗保险受益人的住院和门诊代码与 VEHSS 诊断病例定义相匹配，这些病例定义被组织成 17 类眼部和视力障碍，按 ICD-10 分类。受益人在每个类别中只记录一次，但允许匹配多个类别。分析包括患者人口统计学和眼部疾病患病率的描述性统计。
我们确定了 4548897 名 TRICARE Prime/Plus 受益人的数据（54.86%为男性，45.14%为女性），其中 2018 年至少有 22.93%的人被诊断出患有至少一种疾病。在这些诊断患者中，大多数为男性（50.13%）、成年人（74.91%），以及高级 enlisted rank（57.83%），这些人作为社会经济指标。屈光不正和调节障碍最为常见，其次是传染性和炎症性疾病。包括弱视和斜视、传染性和炎症性疾病以及糖尿病并发症在内的潜在可预防和可治疗的疾病，影响了多达 22%的视力障碍患者。
本研究首次在普遍参保、社会经济多样化的人群中使用 VEHSS 措施。识别潜在可治疗或可预防的疾病表明，在军事医疗系统中，有很大的机会减轻眼部和视力障碍的负担。
