The Economic Burden of Vision Loss and Blindness in the United States
The Economic Burden of Vision Loss and Blindness in the United States
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DOI：
10.1016/j.ophtha.2021.09.010
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发表时间：
2022-03-18
期刊：
影响因子：
13.7
通讯作者：
Saaddine, Jinan
中科院分区：
文献类型：
--
作者：
Rein, David B.;Wittenborn, John S.;Saaddine, Jinan
目的：评估美国和各州视力丧失（VL）的经济负担。设计：分析二手数据来源（美国社区调查[ACS]，美国时间使用调查，劳工统计局，医疗支出小组调查[MEPS]，国家和州卫生支出账户，以及国家健康访谈调查[NHIS]）使用归因分数，回归，和其他方法来估计VL的增量直接和间接成本2017.参与者：人与一个问题，问他们是否是盲人或有严重的困难，即使在ACS，MEPS，或NHIS戴眼镜的回答是肯定的.主要结果测量：我们估计了医疗、疗养院（NH）和支持性服务的直接成本，以及缺勤、家庭生产损失、劳动力参与减少和非正式护理的间接成本，这些成本按年龄组、性别和州分列，并按VL患者的总体和人均计算。我们估计VL的经济负担为1342亿美元：直接成本为987亿美元，间接成本为355亿美元。最大的负担组成部分是NH（418亿美元），其他医疗保健服务（309亿美元）和劳动力参与减少（162亿美元），所有这些都占总额的66%。VL患者每年增加的负担为16838美元。非正式护理是0至18岁人群的最大负担，劳动力参与率下降是19至64岁人群的最大负担，NH费用是65岁或以上人群的最大负担。纽约、康涅狄格州、马萨诸塞州、罗得岛和佛蒙特州的VL人均成本最高。敏感性分析表明，总负担可能在76美元和2180亿美元之间，这取决于在model.Conclusions中使用的假设：自我报告的VL对美国造成了巨大的经济负担。负担在不同年龄以不同的方式累积，导致各州根据VL人口的年龄构成在人均成本构成方面存在差异。有关州际差异的信息可以帮助当地决策者更好地确定资源目标，以解决VL的负担。(C)2021年美国眼科学会
Purpose: To estimate the economic burden of vision loss (VL) in the United States and by state.Design: Analysis of secondary data sources (American Community Survey [ACS], American Time Use Survey, Bureau of Labor Statistics, Medical Expenditure Panel Survey [MEPS], National and State Health Expenditure Accounts, and National Health Interview Survey [NHIS]) using attributable fraction, regression, and other methods to estimate the incremental direct and indirect 2017 costs of VL.Participants: People with a yes response to a question asking if they are blind or have serious difficulty seeing even when wearing glasses in the ACS, MEPS, or NHIS.Main Outcome Measures: We estimated the direct costs of medical, nursing home (NH), and supportive services and the indirect costs of absenteeism, lost household production, reduced labor force participation, and informal care by age group, sex, and state in aggregate and per person with VL.Results: We estimated an economic burden of VL of $134.2 billion: $98.7 billion in direct costs and $35.5 billion in indirect costs. The largest burden components were NH ($41.8 billion), other medical care services ($30.9 billion), and reduced labor force participation ($16.2 billion), all of which accounted for 66% of the total. Those with VL incurred $16 838 per year in incremental burden. Informal care was the largest burden component for people 0 to 18 years of age, reduced labor force participation was the largest burden component for people 19 to 64 years of age, and NH costs were the largest burden component for people 65 years of age or older. New York, Connecticut, Massachusetts, Rhode Island, and Vermont experienced the highest costs per person with VL. Sensitivity analyses indicate total burden may range between $76 and $218 billion depending on the assumptions used in the model.Conclusions: Self-reported VL imposes a substantial economic burden on the United States. Burden accrues in different ways at different ages, leading to state differences in the composition of per-person costs based on the age composition of the population with VL. Information on state variation can help local decision makers target resources better to address the burden of VL. (C) 2021 by the American Academy of Ophthalmology