Visual Impairment, Treatment and Effects on the Elderly

老年人视力障碍、治疗及其影响

• 批准号: 8039800
• 负责人: FRANK A SLOAN
• 金额: $ 33.2万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8039800
• 关键词: Visual; Impairment; Treatment; Effects; Elderly

DESCRIPTION (provided by applicant): This 3-year study has 3 specific aims: (1) Examine patterns of longitudinal use of eye care diagnostic and therapeutic services for major eye diseases; (2) Assess whether visual loss has been reduced by new innovations in ocular therapy for age-related macular degeneration (AMD) and greater intensity of therapy in diabetic eye diseases (both systemic and ocular); and (3) Assess utilization, conformance with guidelines, and cardiovascular, cerebrovascular, and nephropathy outcomes. Aim 1 investigates hyperbolic discounting as an explanation of nonuse and diffusion of new therapies for treatment of AMD. Aim 2 performs comparative effectiveness analysis of effects of AMD therapies and diabetic eye therapies on visual and other complications. Aim 3 investigates effects of diagnostic and therapeutic procedures, including prescribed drugs, on cardiovascular, cerebrovascular, and nephropathy outcomes using instrumental variable (IV) and control function methods. To complement the IV analysis, this study investigates the process of selection into care, assessing roles of such observables as clinical, demographic and financial factors on selection. National, longitudinal data bases to be used include: Medicare 5% claims data merged with vital statistics information from 1991-2010; Health and Retirement Survey data on Medicare beneficiaries merged with Medicare claims for 1993-2008; and Medicare Current Beneficiary Survey data also merged with administrative information from Medicare, 1991-2009. PUBLIC HEALTH RELEVANCE: This study provides important information about reasons individuals use Medicare-covered services. New and promising treatments in age-related macular degeneration have been developed but their effects on long-run visual outcomes and associated complications in a national setting remain to be demonstrated. Our study will provide recent national evidence on these issues. We will document whether appropriate use of recommended care and therapeutic procedures leads to better health outcomes among persons with (1) major eye diseases and (2) diagnosed with diabetes mellitus.

描述（由申请人提供）：这项为期三年的研究具有3个具体目的：（1）检查对主要眼病的眼保健诊断和治疗服务的纵向使用模式； （2）评估视觉丧失是否已通过眼科治疗中的新创新来减少与年龄相关的黄斑变性（AMD）和糖尿病眼病（全身性和眼镜）的疗法强度更高的视觉丧失； （3）评估利用率，符合准则，心血管，脑血管和肾病结果。 AIM 1调查双曲线折现，以解释不使用和扩散AMD治疗的新疗法。 AIM 2对AMD疗法和糖尿病眼疗法对视觉和其他并发症的影响进行比较有效性分析。 AIM 3研究了使用仪器变量（IV）和控制功能方法，研究诊断和治疗程序（包括处方药）对心血管，脑血管和肾病结果的影响。为了补充静脉分析，本研究调查了选择护理的过程，评估了临床，人口统计和财务因素在选择中的可观察到的作用。要使用的国家，纵向数据基础包括：Medicare 5％索赔数据与1991 - 2010年的重要统计信息合并；关于1993 - 2008年Medicare索赔的医疗保险受益人的健康和退休调查数据； Medicare当前的受益人调查数据还与Medicare的管理信息合并，1991- 2009年。 公共卫生相关性：本研究提供了有关个人使用医疗保险覆盖服务的原因的重要信息。已经开发了与年龄相关的黄斑变性的新的和有前途的治疗方法，但是它们对长期视觉结果的影响以及在民族环境中的相关并发症仍有待证明。我们的研究将为这些问题提供最新的国家证据。我们将记录适当使用建议的护理和治疗程序是否会导致（1）主要眼部疾病患者和（2）被诊断出患有糖尿病的人的健康状况。