Health and Economic Aspects of Ocular Disease in the US

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DESCRIPTION (provided by applicant): Despite the importance of visual impairment (VI) and ocular conditions as a public health problem there has been relatively little research on the influence of these conditions on economic consequences, morbidity and mortality. The proposed investigative team is currently funded by the National Eye Institute (NEI) to help address this knowledge gap using data from the National Health Interview Survey (NHIS). To this rich source of data on nationally representative samples of visually impaired adults we propose to study over 116,000 NHIS participants who were also enrolled in the1996-2005 Medical Expenditure Panel Surveys (MEPS). Unique features of the MEPS include visual impairment information on all adult family members and detailed information on quality of life, and medical expenditures, including vision aids, which are not available in the NHIS. Mortality linkage is available for MEPS participants. Our research team will pursue three research aims: 1) Using structural equation modeling (SEM), examine the association between visual impairment status, prevalence of other ocular conditions, health behaviors, health conditions, economic consequences, ocular health care utilization, morbidity, and mortality; 2) Estimate and compare quality-adjusted life years (QALYs) for visually impaired adults and those with selected ocular conditions in subgroups of interest; and 3) Using annual trend data, and (if appropriate) pooled cross-sectional data from the 1996-2005 MEPS, provide comprehensive descriptive statistics on ocular care expenditures, ocular treatments, and ocular prescription drug use. Calculate the proportion of ocular health care expenditures relative to total household income and the average per-person direct medical expenditure cost attributable to ocular conditions after adjustment for the presence of other health conditions. Proposed study aims will also support program goals #1 and #5 of the NEI ocular epidemiology strategic planning report: 1) Determine the burden of eye diseases and their visual outcomes in a changing population, particularly disparities in the burden and the influences of social cultural and demographic factors, and 2) Identify and assess the strategies that will overcome barriers to eye care and convert evidence-based findings into improved patient and population outcomes.