Research published in JAMA Ophthalmology sought to determine the number and location of pediatric ophthalmologists across the U.S., and how that correlation relates to patients’ socioeconomic status.
Tell me about the study.
Investigators conducted a cross-sectional study consisting of 1,056 pediatric ophthalmologists (57.9% men, 42.1% women) who practiced across the United States. Geographic distribution data was collected from the public databases of the American Academy of Ophthalmology (AAO) and the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) in March 2022.
What did they find?
Out of the 3,142 counties in the U.S., 90% (2,828) had no pediatric ophthalmologist and in 4 of the 50 states, there were 0 pediatric ophthalmologists (New Mexico, North and South Dakota, and Vermont). The states with the most pediatric ophthalmologists included California (11%), New York (9.2%), Florida (6.5%), and Texas (5.9%).
What else?
Counties with at least one practicing pediatric ophthalmologist also reported a $17K higher median household income than counties with no practitioner ($70K vs $53K).
Further, a difference between families with and without (8% vs 4.%) internet access; a difference in proportions of patients >19 years old without health insurance (5.7% vs 4.1%); and a difference in households with and without vehicle access (2.1% vs 1.8%) was also greater in counties with one more pediatric ophthalmologist.
Any limitations to the study?
The authors noted that pediatric ophthalmologist listings from the AAO and AAPOS websites may include those clinicians no longer in practice or include an incorrect/outdated practice address.
Conversely the listings may also exclude recent graduations, those clinicians who have recently opened practice, or who denied the organizations’ permission to publish their practice location—resulting in potential under representation across the country.
Other limitations include the usage of select demographic data as well as the usage of the U.S. Census data, which excludes larger groups of patients (undocumented immigrants or international persons).
Take home?
The findings suggest that disparities in pediatric ophthalmology access in the U.S. are present, in large part due to socioeconomic and demographic differences, and have grown steadily over the last 15 years.
The authors recommend that further studies be conducted to examine whether these disparities are impacting the use of pediatric ophthalmology services and, as a result, patient outcomes.