Studies on how visual impairment (VI) impacts subsequent medical care—from financial burden to frequency of both non-ophthalmic and ophthalmic visits—are scant, along with investigations comparing this metric between those with VI vs. people with other disabilities and healthy individuals. Looking into this association, a new study conducted in Taiwan found that subjects with VI undergo less non-ophthalmic care than those with other disabilities.
The investigation included patients age 20 or older with a newly developed visual disability over a 10-year period (2007 through 2017). All patients were observed until they became visually impaired, after which point they were then matched with two control groups: subjects with nonvisual disability and people without any disability. Other disabilities beyond VI were categorized as hearing, dementia, limb, intellectual, mental, organ and “other.” The researchers considered ophthalmic outpatient and inpatient use, in addition to non-ophthalmic outpatient and inpatient usage.
Compared with people experiencing non-visual disability, the case group had lower non-ophthalmic outpatient costs (about $1,540 US) and three fewer outpatient visits. As expected, the opposite was noted for ophthalmic visits/accrued costs in the case group compared with the participants with other disabilities and healthy individuals.
Age influenced medical care differently in those with VI compared with the other two groups (the majority of patients in the study were 65 or older). Specifically, the investigators noted a dose-dependent effect on age in VI individuals receiving non-ophthalmic care and a slight nonlinear age-related trend in ophthalmic care, with the oldest group having the lowest rate. Considering ophthalmic care, this finding could be due to the likelihood that older populations with disabilities are the most vulnerable and may already be using high medical care, making the additional care use insignificant, the authors said. Another possible explanation is that being newly disabled “shocks” younger individuals into action, they added.
“Medical care use is not always lower for people with VI and depends on whether we compare it with people with other disability type or people without disability as well as use type,” the study authors wrote in their paper.
Differences in medical care use may reflect differences in actual medical demands, so policies should ensure that health care needs are met for people with visual disability, they suggested.
Hou CH, Pu C. Association between visual impairment and health care utilization. Am J Ophthalmol. August 15, 2021. [Epub ahead of print].