Health and Economic Aspects of Ocular Disease in the US

描述（由申请人提供）：尽管视力损害（VI）和眼部疾病作为公共卫生问题的重要性，但关于这些疾病对经济后果、发病率和死亡率的影响的研究相对较少。拟议的调查小组目前由国家眼科研究所（NEI）资助，以帮助利用国家健康访谈调查（NHIS）的数据解决这一知识差距。对于这个具有全国代表性的视障成年人样本的丰富数据来源，我们建议研究116，000多名NHIS参与者，他们也参加了1996 -2005年的医疗支出小组调查（MEPS）。MEPS的独特之处包括关于所有成年家庭成员的视力障碍信息，以及关于生活质量和医疗支出的详细信息，包括视力辅助设备，这是NHIS中没有的。MEPS参与者可获得死亡率联系。本研究团队将追求三个研究目标：1）使用结构方程模型（SEM），检验视力障碍状况、其他眼部疾病患病率、健康行为、健康状况、经济后果、眼部保健利用、发病率和死亡率之间的关系; 2）估计和比较视力受损成人和有特定眼部疾病的人在感兴趣的亚组中的质量调整生命年（Qs）; 3）使用年度趋势数据，以及（如适用）来自1996-2005年MEPS的汇总横截面数据，提供有关眼部护理支出、眼部治疗和眼部处方药使用的综合描述性统计数据。计算眼部保健支出相对于家庭总收入的比例，以及调整其他健康状况后，归因于眼部疾病的人均直接医疗支出成本。拟议的研究目标还将支持NEI眼部流行病学战略规划报告的计划目标#1和#5：1）确定在不断变化的人口中眼病的负担及其视力结果，特别是社会文化和人口因素的负担和影响的差异，2）确定和评估将克服眼科护理障碍的策略，并将基于证据的发现转化为改善的患者和人群结果。

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.