Direct Costs of Blindness Experienced by Patients Enrolled in Managed Care

Kevin D. Frick, John G. Walt, Tina H. Chiang, John J. Doyle, Lee S. Stern, Laura M. Katz, Margarita Dolgitser, Sarah K. Hendlish

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate total and condition-related charges incurred by blind patients in a managed care population in the United States and compare total charges with those of a matched nonblind cohort. Design: Retrospective cohort study. Participants: Patients with blindness (N = 10 796) and a 1:1 matched cohort of nonblind patients were selected from a managed care claims database. All study subjects were required to be ≥18 years old at diagnosis (blind patients) or enrollment (nonblind patients) and to have had ≥1 years of continuous follow-up. Methods: Total and pharmacy-related direct medical charges in the first year of follow-up were calculated for both blind and nonblind cohorts. Among blind patients, condition-related charges, charge per treated person, and charge breakdown by age group were calculated. For patients with follow-up extending past 1 year, total charges (both cohorts) and condition-related charges (blind cohort only) were assessed and annualized. Mean and median charges were assessed for blind and nonblind patients within each stratum of matched covariates; a multivariate linear regression assessed the statistical significance of the difference in charges between the 2 cohorts. Main Outcome Measures: Total health care charges in the first year of follow-up and condition-related health care charges in the first year of follow-up for blind patients. Results: For the blind population (mean age, 52 years [standard deviation (SD), 17.5]), the total mean and median health care charges per person in the first year were $20 677 (SD, $48 835) and $6854, respectively. Total mean and median health care charges per nonblind patient in the first year were $13 321 (SD, $40 059) and $3778, respectively. Condition-related charges among blind patients were substantially lower than total charges, with mean and median charges per person of $4565 (SD, $17 472) and $371, respectively. After adjusting for covariates, blind patients had significantly higher total health care charges in the first year of follow-up than nonblind patients (P<0.0001). Costs of the blind did not differ substantially from costs of the normally sighted in subsequent years of follow-up. Conclusion: This study demonstrates the substantial direct cost burden of blindness during the first year of follow-up in a managed care population.

Original languageEnglish (US)
Pages (from-to)11-17
Number of pages7
JournalOphthalmology
Volume115
Issue number1
DOIs
StatePublished - Jan 1 2008

ASJC Scopus subject areas

  • Ophthalmology

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