Age–Related: Macular Degeneration AND Health care resource utilisation in a one year longitudinal study

Abstract

Abstract: : Purpose:Routine diagnostics and treatment are not the only services for patients with Age related macular degeneration (ARMD). Magnifying devices, disease related in–and outpatient care, private nursing and other resources are frequently needed. Here we investigated the health care resource utilisation of patients with ARMD in a longitudinal study.Methods:200 patients with all stages of ARMD where recruited to assess their health care resource utilisation. Patients reported time and costs associated with medical treatments, hospitalisations, glasses, magnifying devices, nursing and other medical aids at baseline, 3, 6 and 12 month. Examinations also included ETDRS visual acuity, ophthalmoscopy, fundus photography and National Eye Institute Visual Function Questionnaire (NEI–VFQ). Results: While hospital visits, regular outpatient care and the use of emergency units remained quite stable over time, the need for additional home nursing, and paid help with everyday tasks like shopping, cooking and transportation increased and was significantly related to decrease of visual acuity and declining health–related quality of life. For instance 12% of patients required help with meal preparation at baseline compared with 31% after one year. The use of magnifying devices increased from 47% to 62%. Conclusions: As their disease progresses over the course of one year patients with ARMD tend to utilise more health care resources in terms of additional home nursing and paid help with every day tasks. A longer follow up period may be required to show increases in hospital visits, emergency room visits and regular outpatient care. Significant parts of the generated cost are borne out of pocket by the patient in order to cope with the disease. The extra burden of ARMD patients should not be underestimated in health economic models of ARMD.

Keywords: age–related macular degeneration • quality of life • clinical (human) or epidemiologic studies: health care delivery/economics/manpower