PDF(Pubmed)
Abstract：
UNASSIGNED: Investigating disparities in service coverage of pediatric optometrists and pediatric ophthalmologists in relation to patient demographics will illuminate vulnerable populations and inform future interventions.
UNASSIGNED: To characterize the geographic distribution of pediatric eye care practitioners and analyze its association with population demographics.
UNASSIGNED: In this cross-sectional study, 4 public databases were used to identify the addresses of pediatric optometrists and pediatric ophthalmologists in the US in April 2023. Addresses were geocoded, and population demographic data were collected. Pediatric optometrists and pediatric ophthalmologists listed in the public databases, as well as respondents to the 2020 US census, were included in this study. Data were analyzed from April to July 2023.
UNASSIGNED: Public databases and US census data of eye practitioners and their practice locations.
UNASSIGNED: Geographic distribution of pediatric optometrists and pediatric ophthalmologists as listed in public databases and correlations between service coverage and US population demographics.
UNASSIGNED: A total of 586 pediatric optometrists (302 female [51.5%]) and 1060 pediatric ophthalmologists (590 male [55.7%]) were identified. Among US counties, 203 (6.5%) had at least 1 pediatric optometrist, and 308 (9.7%) had at least 1 pediatric ophthalmologist, showing substantial geographic overlap (odds ratio, 12.7; 95% CI, 9.4-17.4; P < .001). In the 2834 counties without pediatric ophthalmologists, 2731 (96.4%) lacked pediatric optometrists. There were more pediatric ophthalmologists per million people (3.3) compared with pediatric optometrists per million people (2.5) across all states (difference, 0.8; 95% CI, 0-1.9; P = .047). Among counties with practitioners, the median (IQR) number of pediatric optometrists per million people was 7.8 (0.4-245.0), surpassing the median (IQR) number of pediatric ophthalmologists per million people, 5.5 (1.0-117.0). Counties with pediatric ophthalmologists had higher mean (SD) household incomes than counties with pediatric optometrists ($76 126.87 [$21 879.23] vs $68 681.77 [$18 336.40]; difference, -$7445.10; 95% CI, $2519.51-$12 370.69; P = .003) and higher mean (SD) population with bachelor\'s degrees than counties with pediatric optometrists (79 016 [82 503] vs 23 076 [44 025]; difference, -55 940; 95% CI, -73 035 to -38 845; P < .001), whereas counties with neither specialist type had the lowest mean (SD) household income ($57 714.03 [$2731.00] vs $78 388.67 [$18 499.21]; difference, -$20 675.00; 95% CI, -$21 550.90 to -$19 799.10; P < .001) and mean (SD) population with bachelor\'s degrees (5113 [12 875] vs 167 015 [216 486]; difference, -161 902; 95% CI, -170 388.9 to -153 415.1; P < .001) compared with counties with practitioners.
UNASSIGNED: Geographic disparities in pediatric eye care access, compounded by socioeconomic differences, underscore the urgency of augmenting practitioner support in underserved areas.
UNASSIGNED: To characterize the geographic distribution of pediatric eye care practitioners and analyze its association with population demographics.
UNASSIGNED: In this cross-sectional study, 4 public databases were used to identify the addresses of pediatric optometrists and pediatric ophthalmologists in the US in April 2023. Addresses were geocoded, and population demographic data were collected. Pediatric optometrists and pediatric ophthalmologists listed in the public databases, as well as respondents to the 2020 US census, were included in this study. Data were analyzed from April to July 2023.
UNASSIGNED: Public databases and US census data of eye practitioners and their practice locations.
UNASSIGNED: Geographic distribution of pediatric optometrists and pediatric ophthalmologists as listed in public databases and correlations between service coverage and US population demographics.
UNASSIGNED: A total of 586 pediatric optometrists (302 female [51.5%]) and 1060 pediatric ophthalmologists (590 male [55.7%]) were identified. Among US counties, 203 (6.5%) had at least 1 pediatric optometrist, and 308 (9.7%) had at least 1 pediatric ophthalmologist, showing substantial geographic overlap (odds ratio, 12.7; 95% CI, 9.4-17.4; P < .001). In the 2834 counties without pediatric ophthalmologists, 2731 (96.4%) lacked pediatric optometrists. There were more pediatric ophthalmologists per million people (3.3) compared with pediatric optometrists per million people (2.5) across all states (difference, 0.8; 95% CI, 0-1.9; P = .047). Among counties with practitioners, the median (IQR) number of pediatric optometrists per million people was 7.8 (0.4-245.0), surpassing the median (IQR) number of pediatric ophthalmologists per million people, 5.5 (1.0-117.0). Counties with pediatric ophthalmologists had higher mean (SD) household incomes than counties with pediatric optometrists ($76 126.87 [$21 879.23] vs $68 681.77 [$18 336.40]; difference, -$7445.10; 95% CI, $2519.51-$12 370.69; P = .003) and higher mean (SD) population with bachelor\'s degrees than counties with pediatric optometrists (79 016 [82 503] vs 23 076 [44 025]; difference, -55 940; 95% CI, -73 035 to -38 845; P < .001), whereas counties with neither specialist type had the lowest mean (SD) household income ($57 714.03 [$2731.00] vs $78 388.67 [$18 499.21]; difference, -$20 675.00; 95% CI, -$21 550.90 to -$19 799.10; P < .001) and mean (SD) population with bachelor\'s degrees (5113 [12 875] vs 167 015 [216 486]; difference, -161 902; 95% CI, -170 388.9 to -153 415.1; P < .001) compared with counties with practitioners.
UNASSIGNED: Geographic disparities in pediatric eye care access, compounded by socioeconomic differences, underscore the urgency of augmenting practitioner support in underserved areas.
摘要：
■调查儿科验光师和儿科眼科医生的服务范围与患者人口统计学的差异将阐明弱势人群并为未来的干预措施提供信息。
■表征儿科眼科护理从业人员的地理分布，并分析其与人口统计的关联。
■在这项横断面研究中，2023年4月，4个公共数据库用于识别美国儿科验光师和儿科眼科医生的地址。地址是地理编码的，并收集了人口统计数据。在公共数据库中列出的小儿验光师和小儿眼科医生，以及2020年美国人口普查的受访者，包括在这项研究中。数据从2023年4月到7月进行了分析。
■眼科医生及其执业地点的公共数据库和美国人口普查数据。
■公共数据库中列出的小儿验光师和小儿眼科医生的地理分布以及服务范围与美国人口统计之间的相关性。
■共586名儿科验光师（302名女性[51.5%]）和1060名儿科眼科医生（590名男性[55.7%]）。在美国各县中，203（6.5％）至少有1名儿科验光师，308名(9.7%)至少有一名儿科眼科医生，显示出实质性的地理重叠(赔率比，12.7；95%CI，9.4-17.4；P<.001）。在没有儿科眼科医生的2834个县，2731（96.4％）缺乏小儿验光师。在所有州中，每百万人中有更多的小儿眼科医生（3.3）与每百万人中的小儿验光师（2.5）相比（差异，0.8；95%CI，0-1.9；P=0.047）。在有从业者的县中，每百万儿童验光师的中位数（IQR）为7.8（0.4-245.0），超过每百万儿童眼科医生的中位数（IQR），5.5（1.0-117.0）。拥有小儿眼科医生的县的平均家庭收入（SD）高于拥有小儿验光师的县（$76126.87[$21879.23]vs$68681.77[$18336.40]；差异，-$7445.10；95％CI，$2519.51-$12370.69；P=.003），具有学士学位的平均（SD）人口高于具有小儿验光师的县（79016[82503]vs23076[44025]；差异，-55940；95%CI，-73035至-38845；P<.001），而没有专科类型的县的平均家庭收入(SD)最低(57714.03美元[2731.00美元]对78388.67美元[18499.21美元]；差异，-$20675.00；95%CI，-$21550.90至-$19799.10；P<.001）和具有学士学位的平均（SD）人口（5113[12875]vs167015[216486]；差异，-161902；95%CI，-170388.9至-153415.1；P<.001）与有从业者的县相比。
■儿科眼科护理获得的地理差异，再加上社会经济差异，强调在服务不足的地区增加从业者支持的紧迫性。
■表征儿科眼科护理从业人员的地理分布，并分析其与人口统计的关联。
■在这项横断面研究中，2023年4月，4个公共数据库用于识别美国儿科验光师和儿科眼科医生的地址。地址是地理编码的，并收集了人口统计数据。在公共数据库中列出的小儿验光师和小儿眼科医生，以及2020年美国人口普查的受访者，包括在这项研究中。数据从2023年4月到7月进行了分析。
■眼科医生及其执业地点的公共数据库和美国人口普查数据。
■公共数据库中列出的小儿验光师和小儿眼科医生的地理分布以及服务范围与美国人口统计之间的相关性。
■共586名儿科验光师（302名女性[51.5%]）和1060名儿科眼科医生（590名男性[55.7%]）。在美国各县中，203（6.5％）至少有1名儿科验光师，308名(9.7%)至少有一名儿科眼科医生，显示出实质性的地理重叠(赔率比，12.7；95%CI，9.4-17.4；P<.001）。在没有儿科眼科医生的2834个县，2731（96.4％）缺乏小儿验光师。在所有州中，每百万人中有更多的小儿眼科医生（3.3）与每百万人中的小儿验光师（2.5）相比（差异，0.8；95%CI，0-1.9；P=0.047）。在有从业者的县中，每百万儿童验光师的中位数（IQR）为7.8（0.4-245.0），超过每百万儿童眼科医生的中位数（IQR），5.5（1.0-117.0）。拥有小儿眼科医生的县的平均家庭收入（SD）高于拥有小儿验光师的县（$76126.87[$21879.23]vs$68681.77[$18336.40]；差异，-$7445.10；95％CI，$2519.51-$12370.69；P=.003），具有学士学位的平均（SD）人口高于具有小儿验光师的县（79016[82503]vs23076[44025]；差异，-55940；95%CI，-73035至-38845；P<.001），而没有专科类型的县的平均家庭收入(SD)最低(57714.03美元[2731.00美元]对78388.67美元[18499.21美元]；差异，-$20675.00；95%CI，-$21550.90至-$19799.10；P<.001）和具有学士学位的平均（SD）人口（5113[12875]vs167015[216486]；差异，-161902；95%CI，-170388.9至-153415.1；P<.001）与有从业者的县相比。
■儿科眼科护理获得的地理差异，再加上社会经济差异，强调在服务不足的地区增加从业者支持的紧迫性。
