VISUAL IMPAIRMENT, TREATMENT, AND EFFECTS ON THE ELDERLY

视力障碍、治疗及其对老年人的影响

• 批准号: 6724860
• 负责人: FRANK A SLOAN
• 金额: $ 19.17万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-04-15 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6724860
• 关键词: Medicare /Medicaid; clinical research; diabetes mellitus; diabetic retinopathy; diagnosis quality /standard; functional ability; glaucoma; health care cost /financing; health care service evaluation; health care service utilization; health services research tag; human data; human old age (65+); longevity; longitudinal human study; macular degeneration; medical complication; medically underserved population; nursing homes; outcomes research; pathologic process; racial /ethnic difference; therapy compliance; vision

DESCRIPTION: This four-year study has four major objectives. (1) For elderly persons with diabetes mellitus diabetic retinopathy, glaucoma, and macular degeneration -- diseases that can cause serious impairments to vision and blindness -- we will analyze determinants of utilization of eye care services, and whether or not Medicare beneficiaries with diabetes/diabetic retinopathy and glaucoma receive care in accordance with minimal process of eye care standards. Such standards have been disseminated as guidelines by professional organizations. In this phase, we will address these issues. How do data on patient self-report of diagnosis compare with those obtained from physicians' diagnoses? What proportions of persons with the study diseases receive care at least at the minimum level of guidelines? Holding many factors constant, are there racial differences in treatments for these diseases? (2) We will study the longitudinal course of these diseases, measured in terms of visual and general functional status -- physical, cognitive -- and in terms of placement in a nursing home, and survival. We will analyze effects of care on changes in vision and the other outcome measures. Our data are unique both in terms of the length of time over which patients are followed and in the range of health outcome monitored. (3) We will assess the impact of diabetes, glaucoma, and macular degeneration on total Medicare and Medicaid program cost and on costs privately incurred. Program cost will include cost of vision and non-vision services. In our framework, program cost and patient adherence to guidelines will be jointly determined. (4) We will replicate the analysis of the first 2 objectives for complications of diabetes other than for eyes. We will also specify and estimate a dynamic model of utilization of Medicare-covered services by persons with diabetes -- both vision and nonvision care. The main database will be the National Long-Term Care Survey (NLTCS) for 1982-2001, merged with Medicare claims data for 1982-2001. Eleven papers are planned.

描述：这项为期四年的研究有四个主要目标。(1)老年人