Self-reported Function, Health Resource Use, and Total Health Care Costs Among Medicare Beneficiaries With Glaucoma
Self-reported Function, Health Resource Use, and Total Health Care Costs Among Medicare Beneficiaries With Glaucoma
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DOI：
10.1001/jamaophthalmol.2015.5479
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发表时间：
2016-04-01
影响因子：
8.1
通讯作者：
Blumberg, Dana M.
中科院分区：
文献类型：
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作者：
Prager, Alisa J.;Liebmann, Jeffrey M.;Blumberg, Dana M.
重要性 青光眼对非青光眼医疗状况和由此产生的二级医疗保健费用的影响尚不清楚。 目的 评估青光眼 Medicare 受益人自我报告的医疗状况、医疗服务的使用情况和总医疗保健费用。 设计、设置和参与者 使用 Medicare Current 对普通社区 72 587 名 Medicare 受益人进行纵向观察研究受益人调查（2004-2009 年）。数据提取编码工作于 2015 年 1 月开始，并在 2015 年 5 月至 7 月期间进行了分析。 主要结果和措施 自我报告的健康状况、医疗保健服务的使用、调整后的每人年度平均总医疗费用以及调整后的每人年度平均非门诊费用。 结果 参与者为 72 587 名 65 岁或以上的 Medicare 受益人，其中有（n = 4441）和没有（n = 68 146) 在收集调查数据前一年诊断出青光眼。他们的平均年龄为 76.9 岁，其中 43.2% 为男性。回答有关视力障碍调查问题的青光眼患者被分为自我报告视力障碍（n = 1748）和无视力障碍（n = 2639）的患者。患有青光眼的医疗保险受益人住院治疗的调整后赔率较高（赔率 [OR]，1.27；95% CI，1.17-1.39；P
IMPORTANCE The effect of glaucoma on nonglaucomatous medical conditions and resultant secondary health care costs is not well understood.OBJECTIVE To assess self-reported medical conditions, the use of medical services, and total health care costs among Medicare beneficiaries with glaucoma.DESIGN, SETTING, AND PARTICIPANTS Longitudinal observational study of 72 587 Medicare beneficiaries in the general community using the Medicare Current Beneficiary Survey (2004-2009). Coding to extract data started in January 2015, and analyses were performed between May and July 2015.MAIN OUTCOMES AND MEASURES Self-reported health, the use of health care services, adjusted mean annual total health care costs per person, and adjusted mean annual nonoutpatient costs per person.RESULTS Participants were 72 587 Medicare beneficiaries 65 years or older with (n = 4441) and without (n = 68 146) a glaucoma diagnosis in the year before collection of survey data. Their mean age was 76.9 years, and 43.2% were male. Patients with glaucoma who responded to survey questions on visual disability were stratified into those with (n = 1748) and without (n = 2639) self-reported visual disability. Medicare beneficiaries with glaucoma had higher adjusted odds of inpatient hospitalizations (odds ratio [OR], 1.27; 95% CI, 1.17-1.39; P