Document Detail

Medicare expenditures associated with diabetes and diabetic retinopathy.
MedLine Citation:
PMID:  18854789     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: To estimate the expenditures for diabetic retinopathy in the United States by Medicare. METHODS: Retrospective data analysis using the 1997 through 2004 5% Medicare claims data. A case control design was used; eligible beneficiaries were 65 or older and without major ophthalmic conditions (cataract, cataract surgery, and macular degeneration) during the study period. Controls had diabetes but no evidence of diabetic retinopathy. There were two diabetic retinopathy case groups: beneficiaries with nonproliferative diabetic retinopathy (NPDR) and beneficiaries with proliferative diabetic retinopathy (PDR). Analyses quantified annual Medicare payments for case and control groups. RESULTS: A total of 178,383 controls, 33,735 NPDR cases, and 6,138 PDR cases were identified. After adjusting for age, sex, and race, annual average Medicare payments for all care were significantly higher for case groups compared to the control group, as were average payments for ophthalmic care only (all P < 0.0001). In addition, average payments for all care and for ophthalmic care were substantially higher for PDR cases compared to NPDR cases. CONCLUSION: These findings demonstrate substantial expenditures associated with diabetic retinopathy, and with PDR in particular, only part of which is due to ophthalmic care. Delaying progression may be associated with decreased Medicare expenditures.
Jordana K Schmier; David W Covert; Edmund C Lau; G Philip Matthews
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Retina (Philadelphia, Pa.)     Volume:  29     ISSN:  1539-2864     ISO Abbreviation:  Retina (Philadelphia, Pa.)     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-09     Completed Date:  2009-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309919     Medline TA:  Retina     Country:  United States    
Other Details:
Languages:  eng     Pagination:  199-206     Citation Subset:  IM    
Exponent, Inc., Alexandria, Virginia, USA.
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MeSH Terms
Case-Control Studies
Costs and Cost Analysis
Diabetes Mellitus / economics*,  therapy
Diabetic Retinopathy / economics*,  therapy
Health Care Costs
Health Expenditures / statistics & numerical data*
Health Services for the Aged / utilization*
Medicare / utilization*
Retrospective Studies
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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