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The Economic Burden of Vision Loss and Eye Disorders in the United States

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The Economic Burden of Vision Loss and Eye Disorders in the United States COST OF VISION PROBL EMS: The Economic Burden of Vision Loss and Eye Disorders in the United States JUNE 11, 2013 PRESENTED TO: PRESENTED BY: Prevent Blindness America John Wittenborn David Rein NORC at the University of Chicago 55 East Monroe Street 30th Floor Chicago, IL 60603 (312) 759-4000 (312) 759-4004 NORC | Cost of Vision Problems: The Economic Burden of Vision Loss and Eye Disorders in the United States Table of Contents Results in Brief .............................................................................................................. 1 Methodology and Data Sources....................................................................................... 1 Economic Burden ............................................................................................................ 2 Burden Throughout the Lifespan ..................................................................................... 3 Direct and Indirect Costs ................................................................................................. 4 Costs by Payer ................................................................................................................ 5 Economic Burden by State .............................................................................................. 7 Economic Burden per Person .......................................................................................... 8 Medical Costs by Disorder ............................................................................................... 8 Medical Costs per Person.............................................................................................. 10 Loss of Wellbeing .......................................................................................................... 10 Certainty of Results ....................................................................................................... 11 Impact of Parameter Uncertainty ................................................................................... 12 Limitations ..................................................................................................................... 13 Conclusions ................................................................................................................... 15 Introduction ................................................................................................................. 17 Review of the Literature .............................................................................................. 19 The Economic Impact of Vision Problems, 2007 ............................................................ 19 Other Burden Estimates ................................................................................................ 21 Access Economics 2006. The Cost of Visual Impairment in the US ......................... 21 Gordois et al. 2012 An estimation of the worldwide economic and health burden of visual impairment ..................................................................................................... 22 Prevalence of Visual Impairment and Treated Disorders ........................................ 25 The Prevalence of Visual Impairment and Blindness ..................................................... 25 Treated Prevalence of Diagnosed Vision Disorders ....................................................... 27 Medical Costs .............................................................................................................. 30 Medical Costs Attributable to Diagnosed Vision Disorder and Undiagnosed Visual Loss30 Medical Vision Aid and Optometry Visit Costs ............................................................... 32 Medical Costs by Diagnosis ........................................................................................... 33 School Screening Cost ............................................................................................... 36 Identification of School Screening Programs ................................................................. 36 Screening Costs and Uptake ......................................................................................... 36 Federal Assistance Programs .................................................................................... 39 American Printing House for the Blind ........................................................................... 39 FINAL REPORT | I NORC | Cost of Vision Problems: The Economic Burden of Vision Loss and Eye Disorders in the United States National Library Service for the Blind and Physically Handicapped ............................... 39 Low Vision Adaptations and Devices ........................................................................ 41 Assistive Devices .......................................................................................................... 41 Dog Guides for the Blind ............................................................................................... 42 Education Costs .......................................................................................................... 43 Federal Assistance Program Transfer Payments ..................................................... 45 Supplemental Security Income ...................................................................................... 45 Supplemental Nutrition Assistance Program .................................................................. 45 Social Security Disability Insurance ............................................................................... 46 Committee for Purchase from People Who Are Blind or Severely Disabled ................... 47 Tax Losses (Deductions) ............................................................................................... 47 Deadweight Loss ........................................................................................................... 48 Lost Productivity ......................................................................................................... 49 Lost Productivity due to Lower Wages and Reduced Workforce Participation ............... 49 Lost Productivity due to Informal Care ........................................................................... 49 Long Term Care ........................................................................................................... 52 Nursing Home Care ....................................................................................................... 52 Skilled Nursing Facility Care .......................................................................................... 53 Loss of Wellbeing........................................................................................................ 54 Disability Adjusted Life Years (DALYs) .......................................................................... 54 Quality Adjusted Life Years (QALYs) ............................................................................. 55 Economic Burden Results .......................................................................................... 58 Burden by Age Group .................................................................................................... 58 Burden by Payer ............................................................................................................ 59 Economic Burden by State ............................................................................................ 60 One-Way Sensitivity Analysis .................................................................................... 62 Probabilistic Sensitivity Analysis .............................................................................. 64 Conclusions ................................................................................................................. 68 Limitations ..................................................................................................................... 68 Findings of this Report versus the 2007 PBA Estimate .................................................. 69 Discussion ..................................................................................................................... 71 References ................................................................................................................... 74 FINAL REPORT | II NORC | Cost of Vision Problems: The Economic Burden of Vision Loss and Eye Disorders in the United States Table of Tables Table R1. Economic Burden Results, in $ millions .................................................................................. 3 Table 2.1. Results from the current and three previous burden estimates ............................................... 24 Table 3.1. Prevalence of Visual Loss, 2005–2008 NHANES ................................................................. 26 Table 3.2. Prevalent Population with Visual Loss, 2005–2008 NHANES ............................................. 26 Table 3.3. Treated Prevalence of Vision Diagnoses, 2003–2008 MEPS ................................................ 28 Table 3.4. Treated Prevalent Population in Thousands, 2003–2008 MEPS, .......................................... 29 Table 4.1. Medical Costs Attributable to Diagnosed Disorders .............................................................. 31 Table 4.2. Medical Costs Attributable to Undiagnosed Visual Loss ...................................................... 31 Table 5.1. Optometry Visit Costs ...........................................................................................................
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