This study, which is a competing renewal application, has three aims:
In Aim 1, we expand our current ongoing study of longitudinal use of eye care services among the elderly for diabetic retinopathy (DR), glaucoma, and age-related macular degeneration (ARMD) to include cataract. Arm 1 will describe trends in use of therapeutic interventions for the four eye diseases; assess determinants of use of therapeutic procedures for glaucoma, DR, and ARMD, as well as the role of Medicare pricing policies in determining rates of cataract surgery.
Aim 2 will extend our analysis of adherence with practice guidelines for vision care and its effects on visual outcomes to include use of therapeutic services, and their productivity as a function of regular monitoring. We add additional outcome measures not used in our current study, pharmaceutical as well as other therapies, longer time periods for analysis, and new data.
In Aim 3, we assess utilization, adherence to guidelines, the productivity of various therapeutic interventions, and outcomes associated with diabetes mellitus (DM) other than retinopathy (e.g., heart attack, stroke, and amputation) for elderly persons with diabetes mellitus. An econometric framework for assessing joint effects of regular monitoring and treatment will be further developed and implemented. Data for this four-year extension will come from the National Long-Term Care Surveys merged with Medicare claims and enrollment data for 1984-2005, the Medicare 5% sample, and on persons aged 65+ from the Aging Dynamics of the Oldest-Old (AHEAD) and Health and Retirement Surveys (HRS) merged with Medicare claims, and the Current Medicare Beneficiary Survey (MCBS) merged with Medicare claims. Ten papers are anticipated for this four-year study. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Method to Extend Research in Time (MERIT) Award (R37)
Project #
5R37AG017473-07
Application #
7265106
Study Section
Health Services Organization and Delivery Study Section (HSOD)
Program Officer
Haaga, John G
Project Start
2001-04-15
Project End
2009-07-31
Budget Start
2007-08-01
Budget End
2008-07-31
Support Year
7
Fiscal Year
2007
Total Cost
$264,883
Indirect Cost
Name
Duke University
Department
Administration
Type
Schools of Arts and Sciences
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Ou, Yvonne; Grossman, Daniel S; Lee, Paul P et al. (2012) Glaucoma, Alzheimer disease and other dementia: a longitudinal analysis. Ophthalmic Epidemiol 19:285-92
Day, Shelley; Acquah, Kofi; Platt, Alyssa et al. (2012) Association of vitamin D deficiency and age-related macular degeneration in medicare beneficiaries. Arch Ophthalmol 130:1070-1
Day, Shelley; Acquah, Kofi; Lee, Paul P et al. (2011) Medicare costs for neovascular age-related macular degeneration, 1994-2007. Am J Ophthalmol 152:1014-20
Ayyagari, Padmaja; Grossman, Daniel; Sloan, Frank (2011) Education and health: evidence on adults with diabetes. Int J Health Care Finance Econ 11:35-54
Day, Shelley; Acquah, Kofi; Mruthyunjaya, Prithvi et al. (2011) Ocular complications after anti-vascular endothelial growth factor therapy in Medicare patients with age-related macular degeneration. Am J Ophthalmol 152:266-72
Lee, Michael S; Grossman, Daniel; Arnold, Anthony C et al. (2011) Incidence of nonarteritic anterior ischemic optic neuropathy: increased risk among diabetic patients. Ophthalmology 118:959-63
Sloan, Frank A; Ayyagari, Padmaja; Salm, Martin et al. (2010) The longevity gap between Black and White men in the United States at the beginning and end of the 20th century. Am J Public Health 100:357-63
Day, Shelley; Grossman, Daniel S; Mruthyunjaya, Prithvi et al. (2010) One-year outcomes after retinal detachment surgery among medicare beneficiaries. Am J Ophthalmol 150:338-45
Lee, Michael S; Harrison, Andrew R; Grossman, Daniel S et al. (2010) Risk of glaucoma among patients with benign essential blepharospasm. Ophthal Plast Reconstr Surg 26:434-7
Wysong, Ashley; Lee, Paul P; Sloan, Frank A (2009) Longitudinal incidence of adverse outcomes of age-related macular degeneration. Arch Ophthalmol 127:320-7

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