National Study of Ocular Hospitalizations in Medicare Beneficiaries

Abstract

Purpose: To study the characteristics of Medicare beneficiaries hospitalized for ophthalmic conditions.

Design: Cross-sectional study.

Methods: The 2015 National Medicare 100% Inpatient Limited Dataset was analyzed to identify all patients with either an admitting or primary diagnosis for an ophthalmic condition using ICD-9-CM codes. All other hospitalized Medicare patients served for comparison. Comorbidities were calculated using the Elixhauser Comorbidity Index. Multivariable logistic regression was used to determine odds of primary ophthalmic hospitalization after controlling for patient characteristics and medical comorbidities.

Results: For 2015, there were a total of 13 152 Medicare patients with ocular hospitalizations compared to 6 621 005 patients with nonophthalmic events. Most ophthalmic patients were emergent admissions (73.19%) with routine discharges (75.50%) and low rates of inpatient mortality (0.62%). The top admitting diagnoses for nontraumatic and traumatic eye conditions were diplopia (11.69%) and closed fracture of the orbital floor (3.76%), respectively. Patients admitted for eye conditions were more likely to be younger, to be African American, and to have hypertension, valvular heart disease, diabetes, hypothyroidism, AIDS, lymphoma, solid tumor without metastasis, rheumatologic diseases, alcohol and drug abuse, psychoses, and depression compared to the general Medicare inpatient population.

Conclusions: Most inpatient admissions for US Medicare beneficiaries with primary ophthalmic diagnoses were for nontraumatic disorders of the eye and adnexa. Ophthalmic admissions were on average shorter in duration and had lower rates of inpatient mortality compared to nonophthalmic admissions. Patients admitted for eye conditions were more likely to have comorbidities such as hypertension, diabetes, and depression compared to the general Medicare inpatient population.