Purpose

To estimate the economic burden of vision loss (VL) in the United States and by state.

Design

Analysis of secondary data sources (American Community Survey [ACS], American Time Use Survey, Bureau of Labor Statistics, Medical Expenditure Panel Survey [MEPS], National and State Health Expenditure Accounts, and National Health Interview Survey [NHIS]) using attributable fraction, regression, and other methods to estimate the incremental direct and indirect 2017 costs of VL.

Participants

People with a yes response to a question asking if they are blind or have serious difficulty seeing even when wearing glasses in the ACS, MEPS, or NHIS.

Main Outcome Measures

We estimated the direct costs of medical, nursing home (NH), and supportive services and the indirect costs of absenteeism, lost household production, reduced labor force participation, and informal care by age group, sex, and state in aggregate and per person with VL.

Results

We estimated an economic burden of VL of $134.2 billion: $98.7 billion in direct costs and $35.5 billion in indirect costs. The largest burden components were NH ($41.8 billion), other medical care services ($30.9 billion), and reduced labor force participation ($16.2 billion), all of which accounted for 66% of the total. Those with VL incurred $16 838 per year in incremental burden. Informal care was the largest burden component for people 0 to 18 years of age, reduced labor force participation was the largest burden component for people 19 to 64 years of age, and NH costs were the largest burden component for people 65 years of age or older. New York, Connecticut, Massachusetts, Rhode Island, and Vermont experienced the highest costs per person with VL. Sensitivity analyses indicate total burden may range between $76 and $218 billion depending on the assumptions used in the model.

Conclusions

Self-reported VL imposes a substantial economic burden on the United States. Burden accrues in different ways at different ages, leading to state differences in the composition of per-person costs based on the age composition of the population with VL. Information on state variation can help local decision makers target resources better to address the burden of VL.

中文翻译：

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美国视力丧失和失明的经济负担

目的

估计美国和各州视力丧失 (VL) 的经济负担。

设计

使用归因分数分析二级数据源（美国社区调查 [ACS]、美国时间使用调查、劳工统计局、医疗支出小组调查 [MEPS]、国家和州卫生支出账户以及国家卫生访谈调查 [NHIS]） 、回归和其他方法来估计 2017 年 VL 的增量直接和间接成本。

参与者

在 ACS、MEPS 或 NHIS 中，如果有人询问他们是否失明或视力严重困难，则回答是肯定的人。

主要观察指标

我们估计了医疗、疗养院 (NH) 和支持性服务的直接成本，以及旷工、家庭生产损失、劳动力参与减少和非正式护理的间接成本，按年龄组、性别和州合计和人均VL。

结果

我们估计 VL 的经济负担为 1342 亿美元：直接成本为 987 亿美元，间接成本为 355 亿美元。最大的负担部分是 NH（418 亿美元）、其他医疗服务（309 亿美元）和劳动力参与减少（162 亿美元），所有这些都占总数的 66%。那些有 VL 的人每年增加了 16 838 美元的负担。非正式护理是 0 至 18 岁人群的最大负担部分，劳动力参与减少是 19 至 64 岁人群的最大负担部分，NH 成​​本是 65 岁或以上人群的最大负担部分. 纽约、康涅狄格州、马萨诸塞州、罗德岛州和佛蒙特州的 VL 人均成本最高。

结论

自我报告的 VL 给美国带来了巨大的经济负担。负担在不同年龄以不同方式累积，导致基于 VL 人口年龄构成的人均成本构成的州差异。有关状态变化的信息可以帮助当地决策者更好地利用资源来解决 VL 的负担。