Direct costs of blindness experienced by patients enrolled in managed care

Ophthalmology. 2008 Jan;115(1):11-7. doi: 10.1016/j.ophtha.2007.02.007. Epub 2007 May 1.


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 > or =18 years old at diagnosis (blind patients) or enrollment (nonblind patients) and to have had > or =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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blindness / economics*
  • Cost of Illness*
  • Databases, Factual
  • Direct Service Costs*
  • Female
  • Health Services Research
  • Humans
  • Male
  • Managed Care Programs / economics*
  • Middle Aged
  • Retrospective Studies
  • United States
  • Visually Impaired Persons*