Study: patients with poor vision incur greater medical costs

Baltimore-The impact of poor vision costs Medicare more than $2 billion each year for non-eye-care-related concerns, prompting a call by some to put further emphasis on vision health for all Americans.

A study conducted by researchers affiliated with the Potomac Institute for Policy Studies, the Wilmer Eye Institute at Johns Hopkins University School of Medicine, and Pfizer Inc. found that Medicare beneficiaries with vision loss incurred significantly higher costs than those with normal vision. About 90% of those costs were non-eye-related.

The study evaluated a 5% sampling (about 1.5 million cases) of Medicare beneficiaries continuously enrolled from 1999 to 2003. Those with vision loss experienced increases in depression, injuries, and the need for nursing home facilities.

Jonathan C. Javitt, MD, MPH, lead researcher on the study, said Medicare spent $2.14 billion in 2003 on non-eye-related medical costs for those who were blind or had vision loss.

More than half of the cases were attributed to age-related macular degeneration and glaucoma.

A significant number were linked to cataracts that had not been surgically removed, Dr. Javitt added.

All of those conditions are treatable, said H. Dunbar Hoskins Jr., MD, executive vice president for the American Academy of Ophthalmology (AAO). The AAO said Medicare and insurance companies should put a stronger emphasis on providing preventive eye care for all Americans.

"With the soaring costs of health care, this study is an important reminder that preventing vision loss saves both sight and money," Dr. Hoskins said in a prepared statement.

"With this study, we are seeing the serious economic impact of poor vision health on the health-care system and those who pay for it," Dr. Javitt said in a prepared statement.

Priscilla P. Arnold, MD, FACS, who leads the American Society of Cataract and Refractive Surgery's government relations committee, deemed the study "important" and said she hopes it will focus attention on the need for better public eye care.

"Dr. Javitts' study has identified a significant gap and opportunity to address public health care," Dr. Arnold said. "Simple vision assessment by a primary-care provider will not identify either of those diseases in their early stages. The findings of this study indicate that critical opportunities to preserve vision are lost without regular ophthalmic-specific examination and care."