Vision Loss Has Significant Impact on Use of Hospital Resources and Costs for Older Patient

Visual loss or blindness affects nearly 4 million people in the United States.  A national study with broad implications has found that older patients with vision loss who are hospitalized for common disorders are often not identified as requiring special attention, which can affect outcomes, resource use and costs. The study appeared online in the April 4, issue of JAMA Ophthalmology, authored by Alan R. Morse, JD, PhD, President and CEO of Lighthouse Guild, and co-authors William Seiple, PhD, Paul P. Lee, MD, JD, Joshua D. Stein, MD, MS and Nidhi Talwar, MA.

Identifying the presence of vision loss during hospitalization and employing strategies to assist patients could improve outcomes, reduce readmissions and length of stay, and improve patient satisfaction. If adopted throughout the United States, identifying vision loss during hospitalization could result in a cost-savings of more than $500 million annually.

“The findings underscore the importance of understanding the needs of patients with vision loss and addressing opportunities to reduce length of hospital stay, improve patient outcomes and reduce costs.  This model can and should be applied to make all health care more patient-centric” said Dr. Morse.

Thousands of Patients Compared

In reaching their conclusions, Dr. Morse and Dr. Seiple of Lighthouse Guild and Dr. Lee, Dr. Stein and Nidhi Talwar of the University of Michigan, compared data of more than 12,000 patients with vision loss to the same number of patients without vision loss. All patients were hospitalized for common medical conditions, such as joint replacement, digestive disorders, urinary tract infections, heart failure, or pneumonia.

The Findings

Medicare patients with vision loss experienced longer lengths of stay and increased readmission rates, incurring significantly higher costs than people with no vision loss. Similar findings were found for patients who use commercial insurance.

When the findings were extrapolated nationwide, it was estimated that more than $500 million in additional annual costs would be spent caring for patients with vision loss. 

“The number of people with vision loss is projected to increase substantially as rates of macular degeneration, glaucoma, diabetic retinopathy and other eye diseases are expected to rise,” noted Dr. Morse. “Now is the time to put systems in place to coordinate care among healthcare practitioners that adequately address needs associated with vision loss so that patients receive appropriate care during hospitalization.”

“Even after discharge,” he added, “coordinating care among healthcare practitioners does not sufficiently address these needs so patients with vision loss continue to experience challenges.  Hospitalization is stressful but particularly difficult for people with vision loss,” said Dr. Morse. “It is important that their caregivers understand the consequences of vision loss on care needs during hospitalizations and afterward, and identify strategies to minimize any potential negative impact.”

About Lighthouse Guild

Lighthouse Guild is the leading organization dedicated to addressing and preventing vision loss. For more information, visit lighthouseguild.org.

About the Study Authors

Alan R. Morse, JD, PhD, is President and Chief Executive Officer of Lighthouse Guild. He is an Adjunct Professor in the Department of Ophthalmology, College of Physicians & Surgeons, Columbia University.  Dr. Morse was a member of the Advisory Panel on Addressing Disparities of the Patient-Centered Outcomes Research Institute (PCORI).  He is a participant in the ongoing Global Burden of Diseases, Injuries and Risk Factors Study Vision Loss Expert Group and is a current or past director of numerous healthcare organizations including Healthcare Association of New York State (HANYS), Greater New York Hospital Association (GNYHA), the Advisory Board of the McPherson Eye Research Institute (University of Wisconsin), and the Alliance Advancing Non-Profit Healthcare.   

Paul P. Lee, MD, JD, is the F. Bruce Fralick Professor and Chair of the Department of Ophthalmology and Visual Sciences and Director of the W.K. Kellogg Eye Center at the University of Michigan, Ann Arbor.  He is also on the faculty of the University of Michigan, Ann Arbor Institute for Healthcare Policy and Innovation.

William Seiple, PhD, is Chief Research Officer of the Lighthouse Guild Research Institute and Professor of Ophthalmology at NYU School of Medicine, a Research Biologist at the VA in Chicago, Adjunct Professor at the School of Optometry at the State University of NY, Visiting Professor at the Department of Ophthalmology and Visual Science from Chicago and Visiting Professor at the University Pierre at Marie Curie, Paris, France.

Joshua D. Stein, MD, MS, is the Edward T. and Ellen K. Dryer Career Development Professor and Associate Professor for the Department of Ophthalmology and Visual Sciences and Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor. Dr. Stein’s research area of interest is health services research, patterns of eye care in the United States and outcomes of glaucoma surgery.

Nidhi Talwar, MA, is Senior Statistician, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor.