June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Predictors for receiving low vision services: a retrospective big data study based on healthcare insurance claims
Author Affiliations & Notes
  • Miriam Laura Stolwijk
    Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam Public Health research institute, Amsterdam, Netherlands
  • Ruth van Nispen
    Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam Public Health research institute, Amsterdam, Netherlands
  • Stéphanie van der Pas
    Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam, Netherlands
  • Ger van Rens
    Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam Public Health research institute, Amsterdam, Netherlands
  • Footnotes
    Commercial Relationships   Miriam Stolwijk None; Ruth van Nispen Janssen-Cilag NV, Code C (Consultant/Contractor); Stéphanie van der Pas None; Ger van Rens None
  • Footnotes
    Support  Visio Foundation (former Stichting Novum)
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4240. doi:
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      Miriam Laura Stolwijk, Ruth van Nispen, Stéphanie van der Pas, Ger van Rens; Predictors for receiving low vision services: a retrospective big data study based on healthcare insurance claims. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4240.

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

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Abstract

Purpose : We aimed to investigate which characteristics predict receiving Low Vision Services (LVS) in a high-income country.

Methods : A Dutch national health insurance claims database (2015-2018) with data of visually impaired patients was retrieved (Vektis C.V.). Patients received LVS (n=16.829) and/or ophthalmic treatment in 2018 (reference, n=565.496). The reference group was treated for glaucoma, (diabetic) retinal or macular diseases and did not receive LVS. We selected potential predictors (2015-2017): sex, age, socio-economic status, area of residence, ophthalmic diagnosis, physical and mental comorbidity, cataract surgery, intravitreal injections, ophthalmic treatment setting, distance to LVS, general practitioner (GP-care), occupational therapy, low vision aids. A multivariate logistic regression model was internally validated with bootstrapping.

Results : Of the entire study population, 54% was female, 75% was 65-plus, 46% had glaucoma and 24% macular-related diseases. Predictors for receiving LVS in 2018 were living in the north (rural OR 1.70, 95% CI 1.58 to 1.83) or south (rural OR 1.65, 95%CI 1.56-1.74) compared to the west (urban), having physical (OR 1.21, 95%CI 1.14-1.29) or mental comorbidity (OR 1.50, 95%CI 1.41-1.58), treatment in both a general hospital and a specialized ophthalmic center (OR 1.48, 95%CI 1.37-1.60) vs. a general hospital only, GP-care (OR 1.28, 95%CI 1.22-1.33), occupational therapy (OR 2.11, 95%CI 1.96-2.27) and low vision aids (OR 27.87, 95%CI 26.28-29.56). Characteristics associated with a lower odds were older age (OR 0.30, 95%CI 0.27-0.32), treatment in a specialized ophthalmic center (OR 0.82, 95%CI 0.76-0.87) vs. a generic hospital and greater distance to a LVS (OR 0.90, 95%CI 0.88-0.93). The predictive value of the model was: AUC=0.821; optimism=0.0002.

Conclusions : Patients who are more vulnerable regarding comorbidity, who received a prescription of low vision aids, occupational therapy and were treated in multiple treatment settings were most likely to receive LVS. Involved healthcare professionals may already focus on the patient’s (vision) disability. Living in rural areas and living closer seemed to lower the barrier, which might indicate, respectively, a lower pressure on eyecare and easier access. Eyecare practitioners should be aware though that even at older age, LVS can be beneficial.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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