September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
The Impact of Vision Loss on Length of Stay, Readmission and Cost of Inpatient Hospitalization
Author Affiliations & Notes
  • Alan R Morse
    Lighthouse Guild, New York, New York, United States
    Harkness Eye Institute, Columbia University, New York, New York, United States
  • Paul P Lee
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
    Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
  • William H Seiple
    Lighthouse Guild, New York, New York, United States
  • Nidhi Talwar
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
  • Joshua D Stein
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
    Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
  • Footnotes
    Commercial Relationships   Alan Morse, None; Paul Lee, None; William Seiple, None; Nidhi Talwar, None; Joshua Stein, None
  • Footnotes
    Support  Kellogg Foundation, Research to Prevent Blindness (JDS); Linder Fund (ARM)
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Alan R Morse, Paul P Lee, William H Seiple, Nidhi Talwar, Joshua D Stein; The Impact of Vision Loss on Length of Stay, Readmission and Cost of Inpatient Hospitalization. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess to what extent a diagnosis of vision loss affects hospitalization length of stay (LOS), 30 day readmission rates and use of emergency department (ED) services, utilization of physical therapy (PT) and costs.

Methods : All enrollees in a large US managed care network during 2001-2014 hospitalized for 1 of the 9 most common diagnosis related groups (DRGs) were characterized prior to hospitalization as having no record of vision loss, low vision, or blindness (legal blindness or worse), based on ICD-9-CM codes. We matched those with either low vision or blindness to those with no vision loss 1:1 based on discharge diagnosis, age, year of hospitalization, race, sex and overall health. For each condition, we compared the mean LOS, readmission rates, rate of ED visits, use of PT services and cost of the hospitalization for these groups. Multivariable regression was used to assess the impact of vision loss.

Results : 5929 enrollees with low vision or blindness were matched to 5929 persons without vision loss. Across all 9 diagnoses, mean hospitalization LOS was slightly longer for the enrollees with low vision (4.94 days) and over 1 day longer for the enrollees with blindness (5.67 days) compared to the group with no vision loss (4.61 days) (overall ANOVA p<0.0001). The readmission rate was higher among those with low vision (16.0%) and blindness (21.1%) compared to the group with no vision loss (14.7%). The use of ED services was 8 % higher for those with low vision (16.8%) and 29% higher for enrollees with blindness (20.0%) compared to those with no vision loss (readmit rates and ED use p <0.0001). Enrollees with vision loss had a 25% higher odds of requiring hospital readmission (OR=1.25, CI 1.08-1.46, p<0.004) compared to those no vision loss but a 22% decreased odds of receiving PT (OR=0.78, CI 0.62-0.97, p<0.03) compared to those without vision loss.

Conclusions : Comorbid vision loss and blindness complicates hospitalization for common DRGs frequently resulting in longer LOS, greater utilization of health care services after discharge and increased costs. Training hospital staff about the needs of patients with vision loss and developing patient-centric plans to assist them and their caregivers, prior to, during, and following discharge may lead to improved patient outcomes and reduced costs.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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