Association Between Visual Impairment and Health Care Use

PURPOSE: To determine the association between visual impairment (VI) and medical care use. DESIGN: Population-based cohort study. METHODS: The study cohort included individuals from 2007 to 2017. The Disability Registry was used to identify all patients aged ≥20 years who newly developed visual disability. All patients were observed until they became visually impaired (case group). They were then matched with 2 control groups: (1) people with nonvisual disability and (2) people without any disability. The main outcome measures were (1) ophthalmic outpatient and inpatient use and (2) nonophthalmic outpatient and inpatient use. RESULTS: Compared with people with nonvisual disability, those with visual disability demonstrated a lower nonophthalmic outpatient costs (−NT$42,841, P < .001) and outpatient visits (−2.8 times). However, the opposite was noted for ophthalmic use, where people with visual disability used more medical care compared with people with other types of disability and people without disability. An age-stratified analysis revealed that visual disabilities had an age-related dose–response effect on the reception of nonophthalmic care and a slight nonlinear effect on the receipt of ophthalmic care. CONCLUSIONS: Studies investigating the effect of VI on medical use should differentiate aggregate use into different types. Use of ophthalmic and nonophthalmic care for people with VI should be compared with that of people with other types of disability and people without disability.