Trends in cost of major eye diseases to Medicare, 1991 to 2000.

PURPOSE To estimate impacts of physician-diagnosed eye diseases (age-related macular degeneration (AMD), cataract, diabetic retinopathy, and glaucoma) on Medicare payments in the periods 1991 to 1995 and 1996 to 2000. DESIGN A retrospective cohort study to estimate program payments per capita and in total for each of the major eye diseases and the four eye diseases in total. METHODS Data from the 1994 and 1999 National Long-Term Care Survey (NLTCS) and medical claims to Medicare from 1991 to 2000 were merged with the NLTCS. Medicare payments for eye-related procedures on persons with and without major eye diseases as reported on Medicare claims and self-reported data from NLTCS. RESULTS Overall, the burden of major eye diseases was to increase Medicare spending by 4.8 billion dollars (1999 USD) in 1991 to 1995 and by 4.5 billion dollars in 1996 to 2000. The most expensive eye disease was cataract, costing Medicare 3.8 billion dollars in 1991 to 1995 and 3 billion dollars in 1996 to 2000. CONCLUSIONS Prevalence of major eye diseases increased over time, but the effect of major eye diseases on Medicare payments decreased, mainly as a result of lower payments for cataract surgery in the later years.

[1]  Toni Martin,et al.  Physician and Patient Prevention Practices in NIDDM in a Large Urban Managed-Care Organization , 1995, Diabetes Care.

[2]  L. Jönsson,et al.  MODELING COST OF TREATMENT WITH NEW TOPICAL TREATMENTS FOR GLAUCOMA , 1999, International Journal of Technology Assessment in Health Care.

[3]  Andrew F. Smith,et al.  The economic impact of ophthalmic services for persons with diabetes in the Canadian Province of Nova Scotia: 1993–1996 , 2001, Ophthalmic epidemiology.

[4]  John Van Hoewyk,et al.  A multivariate technique for multiply imputing missing values using a sequence of regression models , 2001 .

[5]  P. Zweifel,et al.  The Impact of Aging on Future Healthcare Expenditure , 2006 .

[6]  David W. Wilcox,et al.  Measuring the Value of Cataract Surgery , 2001 .

[7]  Laurie J. Bassi,et al.  Federal budgetary costs of blindness. , 1992, The Milbank quarterly.

[8]  Paul P. Lee,et al.  Effects of changes in self-reported vision on cognitive, affective, and functional status and living arrangements among the elderly. , 2005, American journal of ophthalmology.

[9]  P. Chew,et al.  What is the direct cost of treatment of acute primary angle closure glaucoma? The Singapore model , 2004, Clinical & experimental ophthalmology.

[10]  A. Gray,et al.  Health care expenditures and ageing: an international comparison. , 2003, Applied health economics and health policy.

[11]  T. Einarson,et al.  Cost of Glaucoma in Canada: Analyses Based on Visual Field and Physician's Assessment , 2003, Journal of glaucoma.

[12]  Trevillore E. Raghunathan,et al.  IVEware: Imputation and Variance Estimation Software User Guide , 2002 .

[13]  M. Frenkel.  Analysis of ophthalmic surgical charges for services to Medicare recipients: 1980 and 1985. , 1989, Archives of ophthalmology.

[14]  G. Kobelt-Nguyen,et al.  Costs of treating primary open-angle glaucoma and ocular hypertension: a retrospective, observational two-year chart review of newly diagnosed patients in Sweden and the United States. , 1998, Journal of glaucoma.

[15]  B. Calissendorff.  Costs of medical and surgical treatment of glaucoma. , 2001, Acta ophthalmologica Scandinavica.

[16]  K. Frick,et al.  Economic cost of cataract surgery procedures in an established eye care centre in Southern India , 2004, Ophthalmic epidemiology.

[17]  J Wylie-Rosett,et al.  Ophthalmic referral rates for patients with diabetes in primary-care clinics located in disadvantaged urban communities. , 1995, Journal of diabetes and its complications.

[18]  P. Bernth‐Petersen.  OUTCOME OF CATARACT SURGERY. IV. SOCIO‐ECONOMIC ASPECTS , 1982, Acta ophthalmologica.

[19]  J C Javitt,et al.  Cost effectiveness of current approaches to the control of retinopathy in type I diabetics. , 1989, Ophthalmology.

[20]  E. Berndt,et al.  Medical Care Output and Productivity , 2001 .

[21]  J. Oostenbrink,et al.  Resource Use and Costs of Patients With Glaucoma or Ocular Hypertension: A One-year Study Based on Retrospective Chart Review in the Netherlands , 2001, Journal of glaucoma.

[22]  Lloyd Paul Aiello,et al.  Preventive Eye Care in People With Diabetes Is Cost-Saving to the Federal Government: Implications for health-care reform , 1994, Diabetes Care.

[23]  N. Powe,et al.  Variations in cataract management: patient and economic outcomes. , 1990, Health services research.

[24]  Sally C Stearns,et al.  Time to include time to death? The future of health care expenditure predictions. , 2004, Health economics.

[25]  M. Falk,et al.  Cost-benefit analysis of diabetic eye disease. , 1996, Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde.

[26]  J. Javitt,et al.  Preparing for managed competition. Utilization of ambulatory eye care visits to ophthalmologists. , 1993 .

[27]  Gisèle Soubrane,et al.  The burden of age-related macular degeneration: results of a cohort study in two French referral centres. , 2003, PharmacoEconomics.

[28]  D. Bates,et al.  Diagnosis-Based Risk Adjustment for Medicare Capitation Payments , 1996, Health care financing review.

[29]  J. Keeffe,et al.  Measurement of indirect costs for people with vision impairment , 2003, Clinical & experimental ophthalmology.

[30]  J C Javitt,et al.  The content and cost of cataract surgery. , 1993, Archives of ophthalmology.

[31]  C. Hyde,et al.  What is the cost of blindness? , 2003, The British journal of ophthalmology.

[32]  L. Howie,et al.  Ophthalmic examination among adults with diagnosed diabetes mellitus. , 1993, JAMA.

[33]  S. Felder,et al.  Ageing of population and health care expenditure: a red herring? , 1999, Health economics.