The Economic Factors Impacting the Viability of Pediatric Ophthalmology

Lee, Karen E.; Sussberg, Jake A.; Nelson, Leonard B; Thuma, Tobin

doi:10.3928/01913913-20220817-01

Cited by 13 publications

(6 citation statements)

References 2 publications

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“…Previous reports support our findings of resident preferences towards certain components of the ophthalmic examination [3] . The least likeable components in our study were gonioscopy, ocular motility testing and visual acuity testing.…”

Section: Perception Of the Ophthalmic Examinationsupporting

confidence: 92%

Ophthalmic exam and ophthalmology residents’ subspecialty preference

Leshno,

Prat

2024

Int J Ophthalmol

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AIM: To evaluate residents’ perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination, and to determine if these factors correlate with their choices for fellowship and future career plans. METHODS: This is a cross-sectional study. A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel. Eighty of them (one-half of all ophthalmology residents in 2019) completed it. The first part related to how they perceived each component of the ophthalmic evaluation. The second part related to their future fellowship plans. The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables. Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects. RESULTS: Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects, whereas gonioscopy, ocular motility examination and visual acuity assessment were least likeable. Anterior segment and retina subspecialties were the ones most sought after. Forty-nine respondents (61.3%) noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty. Perceptions of selected components of those evaluations were significantly associated with responders’ intentions to pursue anterior segment, retina, or oculoplastic fellowships (P<0.05). CONCLUSION: Perspectives of residents toward the ophthalmic examination, and most specifically its individual components, play an important role in their choice of subspecialty training.

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Section: Perception Of the Ophthalmic Examinationsupporting

confidence: 92%

Ophthalmic exam and ophthalmology residents’ subspecialty preference

Leshno,

Prat

2024

Int J Ophthalmol

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“…These findings are concerning given that the United States is currently facing an overall pediatric ophthalmology workforce crisis, i.e., severely impacting access to eye care. [20][21][22] We hypothesize that this may further reflect each health care system's familiarity with the insurance type they predominately accept, and conversely, each patient's familiarity with the health care system that most commonly accommodates their insurance. For example, the phone system, appointment scheduling process, and on-line/mobile application patient portals are distinct between the two hospitals.…”

Section: Discussionmentioning

confidence: 99%

A Multicenter Study of Retinopathy of Prematurity Follow-Up Adherence

Mahmud

Karmouta

Strawbridge

et al. 2023

Retina

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Purpose: Characterize clinical and socioeconomic factors that impact follow-up to complete retinal vascularization and subsequent pediatric ophthalmology follow-up in neonates with retinopathy of prematurity. Methods: Medical records of 402 neonates diagnosed with retinopathy of prematurity from neonatal intensive care units at the University of California, Los Angeles Mattel Children's Hospital and the University of California, Los Angeles Santa Monica Hospital, both academic medical centers, and the Harbor-University of California, Los Angeles Medical Center, a safety-net county hospital, were reviewed. Primary study outcomes were the rate of follow-up to complete retinal vascularization and adequate pediatric ophthalmology follow-up. Secondary outcome was the rate of nonretinal ocular comorbidity. Results: In whole-cohort analysis, 93.6% of neonates were followed to complete retinal vascularization, and 53.5% had adequate pediatric ophthalmology follow-up. Public insurance was associated with lower rates of pediatric ophthalmology follow-up (Odds ratio 0.66, 95% confidence interval 0.45–0.98, P = 0.04). Participants screened at the academic medical center had lower rates of pediatric ophthalmology follow-up compared with the safety-net county hospital (50.7% vs. 63.5%, P = 0.034). In subgroup analysis, academic medical center participants with public insurance were less likely to have pediatric ophthalmology follow-up than safety-net county hospital participants with public insurance (36.5% vs. 63.8%, P < 0.001) or those with private insurance at the academic medical center (36.5% vs. 59.2%, P< 0.001). Conclusion: This study identified high follow-up rates to complete retinal vascularization, lower pediatric ophthalmology follow-up rates, and nonretinal ocular comorbidity at all hospitals. Insurance status relative to hospital type was identified as a risk factor for loss to follow-up. This demonstrates a need to further study health care disparities in retinopathy of prematurity infants.

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“…A survey among pediatric ophthalmologists assessed the economic challenges they faced during COVID-19. 63 It showed that 65.1% met a decrease in revenue from OPD greater than 10%, and another 64.3% agreed to a more than 10% decrease in surgical revenue. 20.9% of pediatric ophthalmologists were forced to plan premature retirement because of COVID-19.…”

Section: Impact On Pediatric Ophthalmologistsmentioning

confidence: 97%

Impact of Covid-19 on Pediatric Ophthalmology Care: Lessons Learned

Kaur,

Muralikrishnan,

Hussaindeen

et al. 2023

PHMT

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The COVID-19 pandemic came with many new challenges that forced personal and professional lifestyle modifications. Medical facilities were in scarcity against this new unknown enemy and were challenged with the overloaded patient flow, scarcity of healthcare staff, and evolving treatment modalities with a better understanding of the virus each day. Ophthalmology as a “branch of medicine” suffered challenges initially because of a lack of guidelines for patient management, close working distance during routine examinations, and halt of major surgeries, including cataracts. Pediatric ophthalmology had major implications, as reduced outpatient visits would mean deeper amblyopia, and changed lifestyles, including online classes and home refinement, predisposing children to myopia, digital eye strain, and worsening of strabismus. COVID-19 also unveiled underlying accommodation and convergence anomalies that predisposed pediatric and adolescent patients to an increased prevalence of headache and acute onset esotropia. Teleophthalmology and other innovative solutions, including the use of prism glasses, safe slit-lamp shields, alternative ways of school screening with the use of photoscreeners, performing retinoscopy only when needed, and using autorefractors were among the few guidelines or modifications adopted which helped in the efficient and safe management of pediatric patients. Many pediatric ophthalmologists also suffered in terms of financial constraints due to loss of salary or even closure of private practices. School screening and retinopathy of prematurity screening suffered a great setback and costed a lot of vision years, data of which remains under-reported. Important implications and learnings from the pandemic to mitigate future similar situations include using teleophthalmology and virtual platforms for the triage of patients, managing non-emergency conditions without physical consultations, and utilizing home-based vision assessment techniques customized for different age groups. Though this pandemic had a lot of negative implications, the innovations, modifications, and other important learnings helped pediatric ophthalmologists in navigating safely.

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The Economic Factors Impacting the Viability of Pediatric Ophthalmology

Cited by 13 publications

References 2 publications

Ophthalmic exam and ophthalmology residents’ subspecialty preference

Ophthalmic exam and ophthalmology residents’ subspecialty preference

A Multicenter Study of Retinopathy of Prematurity Follow-Up Adherence

Impact of Covid-19 on Pediatric Ophthalmology Care: Lessons Learned

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