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1.
Journal of the Korean Ophthalmological Society ; : 175-182, 2022.
Artículo en Coreano | WPRIM | ID: wpr-916435

RESUMEN

Purpose@#To identify changes in medical expenditures and health care utilization before and after visual impairment onset, then analyze differences according to visual impairment severity. @*Methods@#Patients aged ≥ 18 years who were registered as visually disabled from 2005 to 2013 were selected using the database from the registry of the disabled and the National Health Insurance Service. The observation period of 3 years before and after the registration was divided into 6-month units (12 points of interest). At each point of interest, medical cost, number of outpatient visits, and length of hospital stay (LOS) were analyzed. The control group was obtained through 1:10 stratification randomization to match sex and age; individuals in the control group were then selected via 1:1 propensity score matching for the premium quantile and residential area. @*Results@#In total, 131,434 patients with visual disability and the same number of non-visually impaired controls were included. Compared with non-disabled individuals, the mean medical cost and number of outpatient visits were higher for patients with visual disability (1.9- and 1.4-fold, respectively, p < 0.001); the LOS was also 3.5 days longer (p < 0.001). The mean medical cost and number of outpatient visits were greater in severely visually disabled patients than in mildly disabled patients (1.6- and 0.5-fold, respectively, p < 0.001); the LOS was also 12 days longer in severely disabled patients (p < 0.001). From 18 months before disability registration, medical costs and LOS increased according to the presence and severity of visual disability; the number of outpatient visits increased uniformly, regardless of disability and severity. @*Conclusions@#More severe cases of visual impairment are associated with greater health care utilization and expenditures. Policy intervention is necessary to ensure that patients receive appropriate treatment and steady health care by reducing the burden of medical expenditures.

2.
Korean Journal of Ophthalmology ; : 235-241, 2021.
Artículo en Inglés | WPRIM | ID: wpr-902332

RESUMEN

Purpose@#To evaluate the safety and efficacy of preservative-free (PF) latanoprost in glaucoma patients. @*Methods@#In this prospective, open-label, observational study, a total of 27 primary open-angle glaucoma patients who used benzalkonium chloride-preserved prostaglandin analogues for at least 6 months were enrolled. After changing the eye drops to PF lataprost, the intraocular pressure (IOP) and ocular surface symptoms and signs were evaluated in all patients on days 0 (first visit, D0), 45 (D45), and 90 (D90). @*Results@#Mean IOP remained stable during the study period (14.0 ± 2.4 mmHg at D0, 13.9 ± 2.0 mmHg at D45, 13.7 ± 2.2 mmHg at D90; p = 0.603). Mean deviation, pattern standard deviation, and best-corrected visual acuity were similar before and after eye drops replacement. Bulbar conjunctival hyperemia, corneal staining, and conjunctival staining were significantly decreased over 90 days (p = 0.025, p < 0.001, p = 0.020, respectively). The ocular surface disease index score showed a statistically significant improvement from 26.4 ± 18.5 at D0 to 19.8 ± 17.0 at D45 and 15.7 ± 15.6 at D90 (p < 0.001). In the evaluation of ocular tolerability, burning symptoms and dryness were significantly decreased (p = 0.001, p = 0.040). @*Conclusions@#The effects of PF latanoprost on reducing IOP were comparable with those of benzalkonium chloride-preserved prostaglandin analogues, but side effects on the ocular surface were much less pronounced when PF latanoprost was used. With this efficacy, PF latanoprost could slow the progression of glaucoma by increasing patient compliance.

3.
Journal of the Korean Ophthalmological Society ; : 55-67, 2021.
Artículo en Coreano | WPRIM | ID: wpr-875077

RESUMEN

Purpose@#To analyze the incidence and treatment costs associated with vision-threatening diabetic retinopathy (VTDR) in type 2 diabetes and to predict future VTDR populations and treatment expenditures. @*Methods@#Using the data from the National Health Insurance Service from 2006 to 2017, we analyzed VTDR treatment costs by year, sex, and age. Based on the results and changes in future population distributions, we estimated the future number and cost of treatments for VTDR. @*Results@#The number of treatments increased by 2.5-fold from 37,634 in 2006 to 96,214 in 2017, and treatment costs increased 3.4-fold from $13,528,587 in 2006 to $45,643,561 in 2017. When analyzed by year, age, and sex, all showed an increasing trend. Future number of treatments was estimated to increase from approximately 96,000 in 2017 to 220,000 by 2030 and treatment costs were projected to increase by 129% from about $45,643,561 in 2017 to about $1,043,055,262 by 2030. @*Conclusions@#As the incidence of VTDR rises due to an aging population and the frequency of intravitreal injections increases due to insurance reimbursement, future treatment expenditures for VTDR are expected to increase as well. Therefore, appropriate policies must be put in place now to secure medical and financial resources to manage VTDR and reduce medical expenditures in the future.

4.
Journal of the Korean Ophthalmological Society ; : 1084-1097, 2021.
Artículo en Coreano | WPRIM | ID: wpr-901028

RESUMEN

Purpose@#To analyze changes in the incidences of chronic and traumatic diseases before and after registration as visually disabled. @*Methods@#The incidence and risk of chronic and traumatic diseases were compared between patients registered as visually disabled from 2005 to 2013 and a control group, selected through 1:1 propensity score matching for age, sex, premium quantile, and residential area distribution. Data from the National Health Insurance Service were used and the observation period was set from 2 years before to 5 years after the time of registration as visually disabled. The incidences (%) of chronic and traumatic diseases at the point of interest were determined as the mean values according to year of registration, and the risk was measured by conditional logistic regression analysis. @*Results@#131,434 visually disabled patients and the same number of non-visually impaired controls were included. The incidences of chronic disease and fall-related injury were higher in the visually disabled group before registration, but gradually decreased and became similar to the control group after registration. In addition, the risk of developing chronic diseases was higher in the visually disabled group until 2 years after registration, while the risk of fall-related injury remained consistently higher in the visually disabled group during the observation period. The incidence and risk of hip fracture in the visually disabled group increased gradually from approximately 1 year before registration and remained consistently higher than in the control group. @*Conclusions@#People with visual disability have higher incidences of chronic diseases than do non-visually impaired people and are at greater risk of traumatic injuries, such as hip fractures or falls. There is a need to establish community infrastructure and expand welfare services for the prevention and early treatment of comorbidities, both for patients with registered visual disabilities and for patients who have not yet registered.

5.
Korean Journal of Ophthalmology ; : 235-241, 2021.
Artículo en Inglés | WPRIM | ID: wpr-894628

RESUMEN

Purpose@#To evaluate the safety and efficacy of preservative-free (PF) latanoprost in glaucoma patients. @*Methods@#In this prospective, open-label, observational study, a total of 27 primary open-angle glaucoma patients who used benzalkonium chloride-preserved prostaglandin analogues for at least 6 months were enrolled. After changing the eye drops to PF lataprost, the intraocular pressure (IOP) and ocular surface symptoms and signs were evaluated in all patients on days 0 (first visit, D0), 45 (D45), and 90 (D90). @*Results@#Mean IOP remained stable during the study period (14.0 ± 2.4 mmHg at D0, 13.9 ± 2.0 mmHg at D45, 13.7 ± 2.2 mmHg at D90; p = 0.603). Mean deviation, pattern standard deviation, and best-corrected visual acuity were similar before and after eye drops replacement. Bulbar conjunctival hyperemia, corneal staining, and conjunctival staining were significantly decreased over 90 days (p = 0.025, p < 0.001, p = 0.020, respectively). The ocular surface disease index score showed a statistically significant improvement from 26.4 ± 18.5 at D0 to 19.8 ± 17.0 at D45 and 15.7 ± 15.6 at D90 (p < 0.001). In the evaluation of ocular tolerability, burning symptoms and dryness were significantly decreased (p = 0.001, p = 0.040). @*Conclusions@#The effects of PF latanoprost on reducing IOP were comparable with those of benzalkonium chloride-preserved prostaglandin analogues, but side effects on the ocular surface were much less pronounced when PF latanoprost was used. With this efficacy, PF latanoprost could slow the progression of glaucoma by increasing patient compliance.

6.
Journal of the Korean Ophthalmological Society ; : 1084-1097, 2021.
Artículo en Coreano | WPRIM | ID: wpr-893324

RESUMEN

Purpose@#To analyze changes in the incidences of chronic and traumatic diseases before and after registration as visually disabled. @*Methods@#The incidence and risk of chronic and traumatic diseases were compared between patients registered as visually disabled from 2005 to 2013 and a control group, selected through 1:1 propensity score matching for age, sex, premium quantile, and residential area distribution. Data from the National Health Insurance Service were used and the observation period was set from 2 years before to 5 years after the time of registration as visually disabled. The incidences (%) of chronic and traumatic diseases at the point of interest were determined as the mean values according to year of registration, and the risk was measured by conditional logistic regression analysis. @*Results@#131,434 visually disabled patients and the same number of non-visually impaired controls were included. The incidences of chronic disease and fall-related injury were higher in the visually disabled group before registration, but gradually decreased and became similar to the control group after registration. In addition, the risk of developing chronic diseases was higher in the visually disabled group until 2 years after registration, while the risk of fall-related injury remained consistently higher in the visually disabled group during the observation period. The incidence and risk of hip fracture in the visually disabled group increased gradually from approximately 1 year before registration and remained consistently higher than in the control group. @*Conclusions@#People with visual disability have higher incidences of chronic diseases than do non-visually impaired people and are at greater risk of traumatic injuries, such as hip fractures or falls. There is a need to establish community infrastructure and expand welfare services for the prevention and early treatment of comorbidities, both for patients with registered visual disabilities and for patients who have not yet registered.

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