Economic impact of visual impairment and blindness in the United States.

OBJECTIVES To assess the economic impact of excess medical and informal care and the health utility loss associated with visual impairment and blindness in adults aged 40 years and older in the United States. METHODS Medical Expenditure Panel Survey data from 1996 to 2002 were pooled to estimate the relationship of visual impairment and blindness with total medical expenditures, components of expenditures, days of informal care received, and health utility. Estimates accounting for the complex sampling design were based on regressions including confounders such as comorbidities and demographics. The aggregate economic impact was estimated by projecting average individual effects to the population of individuals with blindness and visual impairment. RESULTS Blindness and visual impairment were significantly associated with higher medical care expenditures, a greater number of informal care days, and a decrease in health utility. The home care component of expenditures was most affected by blindness. The aggregate annual economic impact included $5.5 billion spent for medical care and the value of informal care as well as a loss of more than 209,000 quality-adjusted life years. CONCLUSIONS Visual impairment has a large effect on home care. Any economic analysis of prevention, treatment, and rehabilitation should account for the fraction of the annual monetary cost and loss of quality-adjusted life years that can be averted.