Access to Eye Care

Lee, Paul P.; Hoskins, H. Dunbar; Hutchinson, B. Thomas; Wong, Brad

doi:10.1001/archopht.125.3.403

Cited by 19 publications

(19 citation statements)

References 10 publications

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“…34 Increasing the use of a "shared care" model where chronic eye diseases are managed jointly by ophthalmologists and optometrists in at-risk areas could potentially take advantage of excess optometrist capacity and relieve some of the need for ophthalmologists. 42,43 This study is subject to several limitations. First, it was not possible to obtain information on the number of ophthalmologists and optometrists located in a geographic area smaller than a county.…”

Section: Discussionmentioning

confidence: 98%

Eye Care Availability and Access Among Individuals With Diabetes, Diabetic Retinopathy, or Age-Related Macular Degeneration

Gibson

2014

JAMA Ophthalmol

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IMPORTANCE Understanding whether differences in the local availability of eye care professionals are related to differences in realized access to eye care is important for assessing whether and where public health efforts are needed to increase access to eye care professionals.OBJECTIVE To examine whether the county-level availability of ophthalmologists and optometrists is associated with measures of realized access to eye care for individuals with diabetes mellitus, diabetic retinopathy, or age-related macular degeneration (ARMD). DESIGN, SETTING, AND PARTICIPANTS We studied a cross-sectional sample of US adults 40 years and older (1098 individuals with diabetes, 345 with diabetic retinopathy, and 498 with ARMD) from the 2005-2008 National Health and Nutrition Examination Survey.MAIN OUTCOMES AND MEASURES Outcomes were whether diabetic individuals reported undergoing a dilated eye examination in the past year, whether individuals were unaware they had diabetic retinopathy, whether diabetic individuals had vision-threatening diabetic retinopathy, and whether individuals were unaware they had ARMD. RESULTSIn logistic regression models that also included individual characteristics, individuals who lived in a county in the highest ophthalmologist availability quartile were less likely to be unaware they had diabetic retinopathy (predictive margin [PM], 66.1%; 90% CI, 48.8%-83.4%; vs PM, 84.1%; 90% CI, 78.7%-89.6%) and were less likely to have vision-threatening diabetic retinopathy (PM, 1.4%; 90% CI, 0.9%-1.9%; vs PM, 2.6%; 90% CI, 1.8%-3.4%) than individuals who lived in a county in the lower 3 ophthalmologist availability quartiles. Individuals who lived in a county in the lowest ophthalmologist availability quartile were more likely to be unaware they had ARMD (PM, 93.8%; 90% CI, 90.6%-97.0%; vs PM, 88.3%; 90% CI, 84.7%-91.9%) than individuals who lived a county in the higher 3 ophthalmologist availability quartiles. Optometrist availability quartiles were not significantly related to any of the outcomes. CONCLUSIONS AND RELEVANCEThe results suggest that efforts to increase access to ophthalmologists to improve outcomes related to diabetic retinopathy or to increase awareness of ARMD should focus on improving access for diabetic individuals who live in counties in the lowest 3 quartiles of ophthalmologist availability and on individuals at risk of ARMD who live in counties in the lowest quartile of ophthalmologist availability.

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Section: Discussionmentioning

confidence: 98%

Eye Care Availability and Access Among Individuals With Diabetes, Diabetic Retinopathy, or Age-Related Macular Degeneration

Gibson

2014

JAMA Ophthalmol

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“…Access to ophthalmic care has been evaluated by visit rates to an eye care provider 8,9 and by the number of providers per 100 000 persons at the United States (US) county level to approximate overuse or underuse. 10 However, the analysis of driving distance or time to health care providers can provide useful information regarding key barriers to access to adequate health care providers in a particular region.…”

mentioning

confidence: 99%

Evaluating Access to Eye Care in the Contiguous United States by Calculated Driving Time in the United States Medicare Population

et al. 2016

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Purpose To quantify the proximity to eye care in the contiguous United States by calculating driving routes and driving time using a census-based approach. Design Cross-sectional study based on United States (US) census data, Medicare payment data, and OpenStreetMap. Participants 2010 US census survey respondents older than 65 years. Methods For each state in the United States, the addresses of all practicing ophthalmologists and optometrists were obtained from the 2012 Medicare Provider Utilization and Payment Data from the Centers for Medicare and Medicaid Services (CMS). The US census data from 2010 then were used to calculate the geo-location of the US population at the block group level and the number of people older than 65 years in each location. Geometries and driving speed limits of every road, street, and highway in the United States from the OpenStreetMap project were used to calculate the exact driving distance and driving time to the nearest eye care provider. Main Outcome Measures Driving time and driving distance to the nearest optometrist and ophthalmologist per state. Results Driving times for 3.79×107 persons were calculated using a total of 3.88×107 available roads for the 25 508 optometrists and 17 071 ophthalmologists registered with the CMS. Nationally, the median driving times to the nearest optometrist and ophthalmologist were 2.91 and 4.52 minutes, respectively. Ninety percent of the population lives within a 13.66- and 25.21-minute drive, respectively, to the nearest optometrist and ophthalmologist. Conclusions While there are regional variations, overall more than 90% of the US Medicare beneficiary population lives within a 30-minute drive of an ophthalmologist and within 15 minutes of an optometrist.

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“…This is compared with 3181 of 18,500 ophthalmologists (17.19%) who practice at an academic medical center in the United States (Dang S, et al IOVS 2021;62:ARVO E-Abstract 1724) 4 . As soon as 2025, it is projected that ophthalmologists will not be able to meet the demand for their services with an aging population (Dang S, et al IOVS 2021;62:ARVO E-Abstract 1724) 2,3,15 . These numbers suggest that optometrists may be required to fill this shortage, and optometric training programs may need to adjust to support this change.…”

Section: Discussionmentioning

confidence: 99%

“…The per-capita number of ophthalmologists is decreasing because of retirement and lagging matriculation rates, whereas the per-capita number of optometrists is only modestly increasing. [1][2][3] Ultimately, rising patient demand is expected to outpace the supply of eye care providers, steadily increasing the strain on hospitals and health care systems at large. To address the anticipated shortage of ophthalmologists, health care leaders will likely adapt by integrating more optometrists in medical centers.…”

mentioning

confidence: 99%

Survey of the Faculty Status of Optometrists at Academic Medical Centers in the United States

Quan¹,

Song

Koepf

et al. 2023

Optom Vis Sci

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This study aimed to quantify the number of optometrists at academic medical centers, along with faculty rank and post-doctoral training programs. METHODS: The official Web sites of academic medical centers and schools of medicine in the United States were examined during the 2021 to 2022 academic year to identify departments of ophthalmology and collect faculty profiles of employed optometrists. Institutional data were cross-referenced and analyzed by geographic distribution. Data were gathered from the Association of Schools and Colleges of Optometry and Accreditation Council on Optometry Education to identify post-graduate training programs in optometry.RESULTS: A total of 192 academic medical centers were identified, of which 121 (63.02%) had a residency or fellowship program in ophthalmology and/or optometry. One hundred twenty-five (65.10%) of these institutions had at least one staff optometrist. Seven hundred eighteen optometrists were found at these institutions, representing 1.83% of the 39,205 practicing optometrists estimated in the United States. Of the 718 optometrists, 369 (51.39%) held an academic appointment at a medical school. The most common academic rank was assistant professor (184 [25.63%]), followed by instructor (138 [19.22%]), associate professor (34 [4.74%]), and full professor (13 [1.81%]). The distribution of academic rank was similar across all regions but varied between institutions as to whether all, some, or none of the optometric faculty were appointed by a medical school. Of 296 optometry residency programs in the United States, 21 (7.09%) were at an academic medical center. Of 15 optometric fellowship programs in the United States, 3 (20%) were at an academic medical center. Of the 192 institutions in this study, 22 (11.46%) had a post-doctoral optometric training program. CONCLUSIONS:This study shows the distribution of academic rank and post-doctoral training programs for optometrists at academic medical centers.

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Access to Eye Care

Cited by 19 publications

References 10 publications

Eye Care Availability and Access Among Individuals With Diabetes, Diabetic Retinopathy, or Age-Related Macular Degeneration

Eye Care Availability and Access Among Individuals With Diabetes, Diabetic Retinopathy, or Age-Related Macular Degeneration

Evaluating Access to Eye Care in the Contiguous United States by Calculated Driving Time in the United States Medicare Population

Survey of the Faculty Status of Optometrists at Academic Medical Centers in the United States

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