Costs of Refractive Correction of Distance Vision Impairment in the United States, 1999–2002
Received 26 January 2006; accepted 21 June 2006. published online 21 September 2006.
Objective
Correctable vision impairment caused by refractive error is common in the United States population. We estimated the direct costs of providing eyeglasses to all Americans (age≥12) who need refractive correction to achieve good distance vision.
Design
Cross-sectional study of a nationally representative sample of United States citizens.
Participants
Participants in the 1999–2002 National Health and Nutrition Examination Survey (NHANES), age ≥ 12 years. The NHANES examines a nationally representative sample of the U.S. noninstitutionalized, civilian population.
Methods
Presenting and corrected visual acuity data were obtained using an autorefractor from 13 211 (93.0%) of the 14 203 participants who visited the NHANES Mobile Examination Center in 1999 through 2002. Need for refractive correction was defined by current use of corrective lenses for distance vision, improvement to good visual acuity following autorefractor correction (using several cutpoints to define good visual acuity), or both.
Main Outcome Measures
Estimates of direct cost for refractive correction (1 pair of complete eyeglasses and a refraction examination) were computed based on Centers for Medicare & Medicaid Services fee schedules for 2000 and also based on expenditure data from the Medical Expenditure Panel Survey.
Results
The NHANES results indicate that >110 million Americans could or do achieve normal vision with refractive correction. The annual direct cost of correcting distance vision impairment is at least $3.8 billion. Of this amount, $780 million represents the annual cost of providing distance vision correction for persons > age 65.
Conclusions
Correctable vision impairment due to refractive error is common in the United States population. These cost estimates provide useful information for public health endeavors aimed at provision of refractive correction to those who need it.
1Division of Epidemiology and Clinical Research, National Institutes of Health, Bethesda, Maryland.
Correspondence to Susan Vitale, Division of Epidemiology and Clinical Research, National Eye Institute, 5635 Fishers Lane, Suite 1100, Bethesda, MD 20814-9301.
Manuscript no. 2006-111.
The National Health and Nutrition Examination Survey (NHANES) is sponsored by the National Center for Health Statistics, Centers for Disease Control and Prevention, Atlanta, Georgia. Additional funding for the NHANES Vision Component was provided by the National Eye Institute, Bethesda, Maryland (Intramural Research Program grant no.: Z01EY000402).
The authors have no financial interest in any aspect of this research.
ABSTRACT