Health Care Charges for Patients with Ocular Hypertension or Primary Open-angle Glaucoma
Presented in part at: American Glaucoma Society meeting, March 2006, Charleston, South Carolina, and Association for Research and Vision in Ophthalmology meeting, May 2006, Fort Lauderdale, Florida.
Received 8 February 2007; received in revised form 10 April 2007; accepted 16 April 2007. published online 22 August 2007.
Objectives
To determine the total and condition-related direct health care charges of patients with ocular hypertension (OH) or primary open-angle glaucoma (POAG) and identify factors that affect these charges.
Design
Retrospective cohort study.
Participants
Patients with OH (n = 36 767) and POAG (n = 72 412) with ≥1 year of continuous enrollment during calendar years 1998 through 2005 in a nationally representative, multimanaged health plan database (PharMetrics).
Methods
First year total health care and condition-related charges were calculated. Subsequently multivariate linear regression models determined the impact of ophthalmic condition (OH or POAG), age, index year, gender, geographic region, payer mix, product type, treatment with glaucoma medication, ocular comorbidities, and systemic comorbidities on these charges.
Main Outcome Measures
Per-person per year first-year total health care and ocular condition-related charges in United States dollars, adjusted for multiple covariates.
Results
Patients with POAG had significantly higher adjusted total and condition-related health care charges during the first year of follow-up than patients with OH in multivariable analysis ($2070 vs. $1990, P<0.0001 and $556 vs. $322 P<0.0001, respectively). Females and older patients had higher total health care charges compared with males and younger patients ($586 or 28.3% more; P<0.0001 and $27 per year or 0.8% per year more; P<0.0001, respectively). However, neither gender nor age were strong determinants of condition-related charges (P = 0.13 and P = 0.052, respectively). Index year, region, payer, and product types significantly dictated both total and disease-related charges. Patients with ocular comorbid conditions, including cataracts, cataract surgery, diabetic retinopathy, and blindness, had significantly higher total and condition-related health care charges than patients without these conditions (P<0.0001).
Conclusion
Total and condition-related health care charges are considerable for patients with OH and POAG. These data identify several factors that dictate these charges.
Available online: August 22, 2007.
1Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
ABSTRACT