Eye care expenditure;
health care reform;
Medical Expenditure Panel Survey;
sociodemographic information;
The Patient Protection and Affordable Care Act;
OF-POCKET COSTS;
VISUAL IMPAIRMENT;
UNITED-STATES;
DISPARITIES;
ACCESS;
INDIVIDUALS;
INSURANCE;
TRENDS;
IMPACT;
D O I:
10.3109/09286586.2013.783081
中图分类号:
R77 [眼科学];
学科分类号:
100212 ;
摘要:
Objective: To evaluate the association between sociodemographic factors and eye care expenditure and to assess the burden of ocular expenditure compared to total health care expenditure. Methods: A retrospective analysis of ocular expenditure in participants of the 2007 Medical Expenditure Panel Survey. Data from 20,620 unique participants aged >= 18 years were evaluated for eye care expenditure by demographic characteristics. Results: A total of 22% of the studied population had eye care expenditures in 2007. Demographic factors significantly associated with higher probability of having eye care expenditures included older age (65+ years 35%, 45-64 years 23%, 545 years 17%), female sex (female 26%, male 19%), higher educational attainment (greater than high school education 25%, less than high school education 17%), having insurance (private 24%, uninsured 13%), and visual impairment (mild 31%, none 22%). Older age, female sex, higher educational attainment, having insurance, and presence of visual impairment were also significantly associated with higher mean eye care expenditure. In those with eye care expenditure, the mean ratio between eye care and total medical expenditure was 24%, with uninsured patients spending 42% of their medical care expenditure on eye care. Conclusions: Demographic factors are associated with both the probability of having ocular expenditure and the amount of expenditure. Of all factors examined, insurance status has the most potential for modification. Policy makers should consider these numbers when devising the terms by which eye care coverage will be provided under the Patient Protection and Affordable Care Act.
机构:
Univ So Calif, Childrens Hosp Los Angeles, Keck Sch Med, Div Res Children Youth & Families,Dept Pediat, Los Angeles, CA 90027 USAUniv So Calif, Childrens Hosp Los Angeles, Keck Sch Med, Div Res Children Youth & Families,Dept Pediat, Los Angeles, CA 90027 USA