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Abstract #15159 Published in IGR 8-4
Costs and utilization of end-stage glaucoma patients receiving visual rehabilitation care: a US multisite retrospective study
Gieser DK; Tracy Williams R; O'Connell W; Pasquale LR; Rosenthal BP; Walt JG; Katz LM; Siegartel LR; Wang L; Rosenblatt LCJournal of Glaucoma 2006; 15: 419-425
PURPOSE: Glaucoma is a prevalent ophthalmologic disease and leading cause of blindness. A retrospective analysis was conducted to evaluate resources and costs for end-stage glaucoma patients receiving visual rehabilitation care (VRC). MATERIALS AND METHODS: A chart review was conducted in 3 United States VRC centers. Charts of patients with primary open-angle glaucoma as the primary cause of vision loss (1998 to 2003) were selected, yielding 81 records. Data were collected from patient-level billing and reimbursement records (ophthalmologist/optometrist visits, glaucoma medications, procedures, and specialized low-vision and glaucoma-related services). Visual rehabilitation services included utilization of low-vision devices, assessment of daily functioning, orientation and mobility training, and patient counseling. RESULTS: Mean age at baseline was 72.7 years [standard deviation (SD) =17.2, range: 29 to 95]. Of those with known sex (n = 77), 55.8% were women. Medicare was the payer type for most patients (59.3%), whereas 20% had Medicaid. Mean number of visits was 7.1 (SD = 6.1) in year 1 and 3.7 (SD = 4.2) in year 2, for an annual mean of 5.4 (SD = 5.0) visits overall. Total mean cost per patient in year 1 was greater than year 2 [$2170 (SD = $2252) vs. $1202 (SD = $1080), respectively]; of the total 2-year costs, 15% were VRC, 37% ophthalmology care, and 48% pharmacy. Analysis of nonpharmacy costs revealed that VRC accounted for 28% and ophthalmology for 72%. CONCLUSIONS: End-stage glaucoma is associated with appreciable resource utilization and costs, because of both vision rehabilitation and ophthalmology care. Advanced primary open-angle glaucoma has a substantial cost-of-illness, warranting improved management in early stages of disease.
Dr. D.K. Gieser, Wheaton Eye Clinic, Wheaton, IL, USA
Classification:
1.5 Glaucomas as cause of blindness (Part of: 1 General aspects)
14 Costing studies; pharmacoeconomics
