Health and Economic Aspects of Ocular Disease in the US

描述（由申请人提供）：尽管视力障碍（VI）和眼部疾病作为一个公共卫生问题很重要，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，利用国家健康访谈调查（NHIS）的数据帮助解决这一知识差距。为了获得具有全国代表性的视障成年人样本的丰富数据来源，我们建议研究超过116,000名NHIS参与者，他们也参加了1996-2005年医疗支出小组调查（MEPS）。MEPS的独特特点包括所有成年家庭成员的视力受损信息，以及关于生活质量和医疗支出（包括助视器）的详细信息，这些都是国家卫生保健系统所没有的。死亡率关联适用于MEPS参与者。我们的研究团队将追求三个研究目标：1)利用结构方程模型（SEM），研究视力损害状况、其他眼部疾病的患病率、健康行为、健康状况、经济后果、眼科保健利用、发病率和死亡率之间的关系；2)评估和比较感兴趣亚组中视力受损成人和选定眼病患者的质量调整生命年（QALYs）；3)利用年度趋势数据，以及1996-2005年MEPS的汇总横截面数据，提供眼科护理支出、眼科治疗和眼科处方药使用的综合描述性统计数据。计算眼科保健支出相对于家庭总收入的比例，以及在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眼科流行病学战略规划报告的项目目标#1和#5:1)确定不断变化的人群中眼病的负担及其视力结果，特别是负担的差异以及社会文化和人口因素的影响；2)确定和评估将克服眼科保健障碍的策略，并将循证结果转化为改善患者和人群的结果。

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.