Hospitalized ocular injuries among persons with low socioeconomic status: a medicaid enrollees-based study

To investigate the incidence of hospitalized ocular injuries by sociodemographic characteristics and type of ocular injury.

Using 1996-1998 Michigan State Medicaid Research Files, ocular injuries were identified by the recorded principal or secondary diagnosis code of International Classification of Diseases, Ninth Revision, Clinical Modification. We excluded persons enrolled in both Medicaid and Medicare and we adjusted for Medicaid enrollment turnover and for repeat admission for the same ocular injury. We calculated overall incidence of hospitalized ocular injuries, relative risk (RR), and associated 95% confidence intervals (95% CI) of injuries by sociodemographic characteristics and by major types of ocular injury.

The average annual incidence of hospitalization for ocular injury was 12.00 per 100,000 full-year-equivalent Michigan Medicaid enrollees. Males had a higher incidence and RR than females (17.3 per 100,000 males vs. 8.1 per 100,000 females; RR = 2.13, 95% CI: 1.70-2.66). The incidence of hospitalized ocular injuries increased with increasing age of the Medicaid enrollee. Disabled individuals had a lower incidence of hospitalized ocular injuries than cash recipients and the medically needy (7.8 per 100,000 disabled enrollees vs. 28.6 per 100,000 cash recipients and 25.7 per 100,000 medically needy enrollees). The three leading types of hospitalized ocular injuries were orbital floor fracture; open wound of eyeball; and open wound of ocular adnexa. The major types of hospitalizations for ocular injury differed significantly by Medicaid eligibility group.

Medicaid enrollees represent a unique subgroup of the U.S. population and their rate of hospitalization for ocular injury is significant. Sociodemographic characteristics, including gender, age, and Medicaid eligibility group, need to be taken into consideration when developing appropriate eye injury prevention initiatives.