Abstract
Purpose :
To investigate the association between glaucoma and motor vehicle accidents (MVA) in the 2019 California (CA) Medicare population, and whether this association differs by race and ethnicity.
Methods :
A cross-sectional study was conducted in the entire population of 2019 CA Medicare fee-for-service beneficiaries. Inclusion criteria were: age 65 or older, CA residence, enrollment in Medicare Parts A and B, and having filed at least one Part B claim in 2019 (i.e., active Part B coverage). The outcome of interest was MVA and the primary exposure was glaucoma, both defined by having International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes for their respective conditions. Multivariable logistic regression was performed to examine the association between glaucoma and MVA, controlling for age, sex, race/ethnicity, and systemic disease burden defined by Charlson Comorbidity Index (CCI) score. Separate multivariable logistic regression models were created to assess the association between glaucoma and MVA stratified by race and ethnicity, and adjusting for age, sex, and CCI score, in order to assess for potential effect measure modification.
Results :
The study sample included 2,717,346 CA Medicare beneficiaries. There were 411,099 (15.1%) beneficiaries with a diagnosis of glaucoma, 1,010,539 (37.2%) who identified as Non-White race, and 9,320 (0.3%) who were involved in an MVA. Beneficiaries with glaucoma had 1.13 times the adjusted odds of MVA (95% confidence interval [CI], 1.07-1.19) compared with beneficiaries without glaucoma. In multivariable models stratified by race and ethnicity, the association between glaucoma and increased adjusted odds of MVA persisted across racial and ethnic groups: Non-Hispanic White (adjusted odds ratio [aOR]: 1.08, 95% CI: 1.00-1.16), Hispanic (aOR: 1.16, 95% CI: 1.01-1.34), Asian (aOR: 1.19, 95% CI: 1.04-1.37), Black (aOR: 1.25, 95% CI: 1.05-1.49) Other (OR: 1.23, 95% CI: 0.95-1.59).
Conclusions :
Glaucoma was associated with a greater likelihood of MVA in the racially and ethnically diverse population of 2019 CA Medicare beneficiaries compared to non-white beneficiaries. Further research is needed to examine strategies to prevent or reduce MVA’s in individuals with glaucoma, with special consideration of the contributions of sociodemographic characteristics to the likelihood of MVA.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.