Visual Impairment, Treatment and Effects on the Elderly

老年人视力障碍、治疗及其影响

• 批准号: 7469455
• 负责人: FRANK A SLOAN
• 金额: $ 24.7万
• 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 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7469455
• 关键词: Academy; Address; Adherence; Adverse event; Advisory Committees; Age; Age related macular degeneration; Aged, 80 and over; American; Americas; Amputation; Area; Association Learning; Biological Preservation; Blindness; Caring; Cataract; Cataract Extraction; Centers for Disease Control and Prevention (U.S.); Chronic; Chronic Disease; Clinical; Code; Complications of Diabetes Mellitus; Cost of Illness; Data; Data Sources; Databases; Depth; Diabetes Mellitus; Diabetic Retinopathy; Diagnosis; Disease; Disease Progression; Elderly; Elements; Enrollment; Evidence Based Medicine; Expenditure; Eye; Eye diseases; Family; Feedback; Frequencies; Future; Glaucoma; Guidelines; Health; Health Care Costs; Health Services; Hospitalization; Incidence; Intervention; Joints; Long-Term Care; Longitudinal Studies; Medical Surveillance; Medicare; Medicare/Medicaid; Methodology; Methods; Monitor; Myocardial Infarction; National Health and Nutrition Examination Survey; Nature; Ophthalmic examination and evaluation; Ophthalmology; Other Therapy; Outcome; Outcome Measure; Paper; Patient-Focused Outcomes; Patients; Patterns of Care; Period Analysis; Personal Communication; Persons; Pharmacologic Substance; Policies; Population; Practice Guidelines; Prevalence; Preventive; Price; Process; Productivity; Provider; Publishing; Randomized Controlled Trials; Rate; Reading; Recommendation; Relative (related person); Research; Research Personnel; Retinal Diseases; Retirement; Role; Sampling; Screening procedure; Services; Societies; Stroke; Subgroup; Surveys; System; Techniques; Testing; Therapeutic Intervention; Therapeutic Uses; Therapeutic procedure; Time; Translating; Upper arm; Vision; Visit; Visual; Visual impairment; Work; administrative database; base; beneficiary; community based care; cost; diabetic; disorder control; follow-up; improved; insight; instrumental activity of daily living; interest; population survey; prevent; programs; racial difference; tool; treatment effect; trend

DESCRIPTION (provided by applicant): This study, which is a competing renewal application, has three aims: In Aim 1, we expand our current ongoing study of longitudinal use of eye care services among the elderly for diabetic retinopathy (DR), glaucoma, and age-related macular degeneration (ARMD) to include cataract. Arm 1 will describe trends in use of therapeutic interventions for the four eye diseases; assess determinants of use of therapeutic procedures for glaucoma, DR, and ARMD, as well as the role of Medicare pricing policies in determining rates of cataract surgery. Aim 2 will extend our analysis of adherence with practice guidelines for vision care and its effects on visual outcomes to include use of therapeutic services, and their productivity as a function of regular monitoring. We add additional outcome measures not used in our current study, pharmaceutical as well as other therapies, longer time periods for analysis, and new data. In Aim 3, we assess utilization, adherence to guidelines, the productivity of various therapeutic interventions, and outcomes associated with diabetes mellitus (DM) other than retinopathy (e.g., heart attack, stroke, and amputation) for elderly persons with diabetes mellitus. An econometric framework for assessing joint effects of regular monitoring and treatment will be further developed and implemented. Data for this four-year extension will come from the National Long-Term Care Surveys merged with Medicare claims and enrollment data for 1984-2005, the Medicare 5% sample, and on persons aged 65+ from the Aging Dynamics of the Oldest-Old (AHEAD) and Health and Retirement Surveys (HRS) merged with Medicare claims, and the Current Medicare Beneficiary Survey (MCBS) merged with Medicare claims. Ten papers are anticipated for this four-year study.

描述（由申请人提供）：本研究是一项竞争性续期申请，有三个目标：在目标1中，我们扩展了目前正在进行的老年人对糖尿病视网膜病变（DR）、青光眼和年龄相关性黄斑变性（ARMD）的眼部护理服务的纵向使用研究，包括白内障。第1组将描述四种眼病治疗干预措施的使用趋势；评估青光眼、DR和ARMD治疗方法使用的决定因素，以及医疗保险定价政策在决定白内障手术率中的作用。目标2将扩展我们对视力保健实践指南的依从性及其对视力结果的影响的分析，包括治疗服务的使用，以及它们作为定期监测功能的生产力。我们增加了当前研究中未使用的额外结果测量、药物治疗和其他治疗、更长的分析时间和新数据。在Aim 3中，我们评估了老年糖尿病患者的使用情况、对指南的遵守情况、各种治疗干预措施的有效性，以及与糖尿病（DM）相关的结果，而不是视网膜病变（如心脏病发作、中风和截肢）。将进一步制订和执行一个计量经济学框架，以评估定期监测和治疗的联合效果。这四年延长的数据将来自国家长期护理调查合并医疗保险索赔和1984-2005年的登记数据，医疗保险5%的样本，65岁以上的老年人老龄化动态（AHEAD）和健康与退休调查（HRS）合并医疗保险索赔，以及当前医疗保险受益人调查（MCBS）合并医疗保险索赔。这项为期四年的研究预计将发表10篇论文。

项目成果

Changes in incidence of diabetes mellitus-related eye disease among US elderly persons, 1994-2005.

• DOI: 10.1001/archopht.126.11.1548
• 发表时间: 2008-11
• 期刊: ARCHIVES OF OPHTHALMOLOGY
• 作者: Sloan, Frank A.;Belsky, Daniel;Ruiz, David, Jr.;Lee, Paul
• 通讯作者: Lee, Paul

Longitudinal rates of postoperative adverse outcomes after glaucoma surgery among medicare beneficiaries 1994 to 2005.

• DOI: 10.1016/j.ophtha.2008.03.033
• 发表时间: 2008-07
• 期刊: Ophthalmology
• 影响因子: 13.7
• 作者: Stein JD;Ruiz D Jr;Belsky D;Lee PP;Sloan FA
• 通讯作者: Sloan FA

Rates of glaucoma medication utilization among older adults with suspected glaucoma, 1992 to 2002.

1992 年至 2002 年疑似青光眼老年人的青光眼药物使用率。

• DOI: 10.1016/j.ajo.2006.12.025
• 发表时间: 2007
• 期刊: American journal of ophthalmology
• 影响因子: 4.2
• 作者: Stein,JoshuaD;Sloan,FrankA;Lee,PaulP
• 通讯作者: Lee,PaulP

Resource use and costs associated with diabetic macular edema in elderly persons.

• DOI: 10.1001/archopht.126.12.1748
• 发表时间: 2008-12
• 期刊: ARCHIVES OF OPHTHALMOLOGY
• 作者: Shea, Alisa M.;Curtis, Lesley H.;Hammill, Bradley G.;Kowalski, Jonathan W.;Ravelo, Arliene;Lee, Paul P.;Sloan, Frank A.;Schulman, Kevin A.
• 通讯作者: Schulman, Kevin A.