Cost, Utilization, and Complications of Corneal Transplant in Affordable Care Act Beneficiaries.

IF 1.2 4区医学 Q3 OPHTHALMOLOGY

Ophthalmic epidemiology Pub Date : 2025-09-02 DOI:10.1080/09286586.2025.2554073

Shravika L Chennupati, George T Lin, Jeremy B Hatcher, Xiangyu Ji, Qingxia Chen, Christine Shieh

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引用次数: 0

Abstract

Purpose: A knowledge gap persists regarding the utilization of corneal transplant surgery among enrollees in Affordable Care Act (ACA) plans and the factors influencing associated costs and complications post-ACA implementation. This study investigates the demographics, costs, and complications of cornea transplant for patients insured under the ACA from 2015 to 2019.

Methods: A novel claims dataset of Affordable Care Act (ACA) marketplace plan subscribers was utilized. Multivariable logistic and linear regression models were used to assess demographics, cost, and complication rates of corneal transplant using demographic/clinical data and insurance plan type.

Results: Among 26,997,610 enrollees, 0.005% (n = 1266) underwent cornea transplant. About 32.9% (n = 416) of patients experienced a postoperative complication, the most common being corneal transplant failure (15.6%) and infectious keratitis (11.5%). Insurance plan type was not associated with rate of postoperative complications (p = 0.87). Patients with different plan types incurred significantly different out-of-pocket (OOP) cost (p < 0.001), with patients on Silver cost-sharing reduction plans paying the lowest ($4).

Conclusion: This study is the first to assess the demographics, costs, and complications of corneal transplant patients within the ACA population. Our findings suggest that patients with higher cost-sharing subsidies experience lower OOP costs and may be more inclined to pursue corneal transplant than those on lower actuarial value plans.

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《平价医疗法案》受益人角膜移植的成本、利用和并发症。

目的：在平价医疗法案（ACA）计划的参保者中，角膜移植手术的使用以及ACA实施后影响相关成本和并发症的因素方面，知识差距仍然存在。本研究调查了2015年至2019年ACA参保患者角膜移植的人口统计学、成本和并发症。方法：利用平价医疗法案（ACA）市场计划订户的新索赔数据集。使用多变量logistic和线性回归模型评估人口统计学、成本和角膜移植并发症发生率，使用人口统计学/临床数据和保险计划类型。结果：在26,997,610名受试者中，0.005% （n = 1266）接受了角膜移植。约32.9% （n = 416）的患者出现术后并发症，最常见的是角膜移植失败（15.6%）和感染性角膜炎（11.5%）。保险计划类型与术后并发症发生率无相关性（p = 0.87）。结论：本研究首次对ACA人群中角膜移植患者的人口统计学、成本和并发症进行了评估。我们的研究结果表明，与精算价值较低的计划相比，成本分担补贴较高的患者OOP成本较低，可能更倾向于进行角膜移植。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ophthalmic epidemiology 医学-眼科学

CiteScore

3.70

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.