Sociodemographic predictors of healthcare utilization and adverse outcomes in Medicare beneficiaries with glaucoma

点击翻译按钮获取中文摘要

PROJECT SUMMARY/ ABSTRACT Patients with glaucoma experience an increased risk of adverse health-related outcomes, including falls, injuries, femur fractures, and depression. In the United States, racial and socioeconomic (SES) disparities exist in glaucoma prevalence, visual impairment, and eye-care utilization. However, we do not know if these disparities result in differences in vision- and health-related outcomes between different groups. Furthermore, while it is known that frailty among older adults has implications for morbidity, mortality, and healthcare costs, the relationship between frailty and healthcare utilization and outcomes in older adults with glaucoma has not been explored. We hypothesize that there are detectable differences on the use of eye care services and subsequently in vision- and health-related outcomes among older adults with glaucoma based on race and SES. We further hypothesize that older adults with a higher frailty score and more comorbidities will be less likely to use eye care services and will have worse vision- and health-related outcomes from glaucoma. To address these hypotheses, we will analyze the existing data from a 5% sample of Medicare beneficiaries from 2014-2016. We will assemble a cohort of glaucoma patients as well as a matched control cohort. Our analyses are aimed at answering 3 specific aims: 1) are there differences in eyecare utilization among older glaucoma patients based on race, SES and frailty and is there an interplay between sociodemographic characteristics and frailty? 2) Are glaucoma patients belonging to vulnerable populations based on race, SES and frailty more likely to experience adverse vision related outcomes? And finally 3) are there differences in health utilization and adverse outcomes among glaucoma patients based on their race and SES? We hypothesize that the impact of glaucoma on overall morbidity and function is unevenly distributed, with vulnerable populations carrying a greater risk or poor health outcomes. The research outlined here will improve our understanding of the complex interplay of factors contributing to disparities in glaucoma care and outcomes. This study will enable us to identify gaps in care among vulnerable populations and identify possible areas for intervention.