The Association between Dual Sensory Impairment and Hospital Admission in the US California Medicare Beneficiaries

Abstract

Purpose : Dual sensory impairment (DSI) showed an increased prevalence with increasing age in the States. Yet, there was relatively less attention on its disease burden. The objective of this study was to assess the association between DSI and all-caused hospitalisation in US California (CA) Medicare beneficiaries.

Methods : A cross-sectional study was conducted among 100% US CA Medicare beneficiaries using the 2015 part A and B carriers claims databases, obtained from the Centers for Medicare & Medicaid Services. Beneficiaries who resided in CA in 2015, age 65 years or older, enrolled in Medicare part A and part B, and had at least 1 part B claim in 2015 were included. Sensory impairment status, including DSI, visual impairment only (VIO), and hearing impairment only (HIO), was classified by having the International Classification of Disease - 9^th and 10^th Edition diagnosis codes in the Part B carrier claims. Hospitalization was defined as at least one inpatient claim in the Part A inpatient claims. Multivariable logistic regression analyses were used to calculate odds ratios (ORs) of hospitalisation for DSI, adjusting for age; sex; race; and systemic comorbidities in terms of Charlson Comorbidity Index score.

Results : The study sample included 2,574,641 CA Medicare beneficiaries. There were 0.1% (n = 3,055), 0.7% (n = 16,896), and 7.1% (n = 181,838) of beneficiaries had DSI, VIO, and HIO, respectively. Patients with DSI were much older than patients with no sensory impairment (NSI). 15.3% (n = 394,004) of all beneficiaries had at least one inpatient visit in 2015. Both unadjusted and fully adjusted models revealed a higher odds of inpatient stay for beneficiaries with DSI compared with beneficiaries with NSI (unadjusted OR = 2.66; 95% CI = 2.46 – 2.87; fully adjusted OR = 1.14; 95% CI = 1.30 - 1.54). Similarly as DSI, subjects with VIO also demonstrated higher odds of hospital admission compared with NSI (fully adjusted OR = 1.48; 95% CI = 1.42-1.53). Beneficiaries with HIO had the same odds of hospitalization as NSI (fully adjusted OR = 1.00; 95% CI = 0.98-1.01).

Conclusions : In a cohort of US CA Medicare beneficiaries, subjects with DSI or VIO had a higher odds of hospitalisation compared with those with NSI. Further studies are needed to identify potential reasons of this relationship, which could be amenable to population health policy interventions.

This is a 2020 ARVO Annual Meeting abstract.