The number of ophthalmologists in practice and training worldwide: a growing gap despite more than 200 000 practitioners

Resnikoff, Serge; Felch, William Campbell; Gauthier, Tina-Marie; Spivey, Bruce E.

doi:10.1136/bjophthalmol-2011-301378

Cited by 323 publications

(229 citation statements)

References 1 publication

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“…Figures from 2010 showed that the United Kingdom has the lowest ratio of ophthalmologists per head of the population in the European Union (5.2 per 100 000). 6 The challenges of providing increased capacity coupled with reduced numbers of medically trained staff have been acknowledged by the Royal College of Ophthalmologists. 7,8 The Royal College of Ophthalmologists position is that, where circumstances and facilities allow, intravitreal injections should be administered by a specialist doctor trained in the procedure.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a nurse-delivered intravitreal injection service

DaCosta

Hamilton

Nago

et al. 2014

Eye

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Purpose The purpose of this study was to introduce nurse-delivered intravitreal injections to increase medical retina treatment capacity. Methods Indemnity, clinical governance, training, planning, and implementation issues were addressed. The outcome measures were patient safety, patient experience, and clinic capacity.Results No serious vision-threatening complications were recorded in a consecutive series of 4000 nurse-delivered intravitreal injections. A Mann-Whitney test showed a significant increase in intravitreal injections (P ¼ 0.003) in the medical retina service after introduction of nurse-delivered intravitreal injections. The majority of patients accepted and were satisfied with a nurse-delivered intravitreal injection. Discussion Nurse-delivered intravitreal injections appear safe, acceptable to patients, and are an effective means to increase intravitreal injection capacity in medical retina clinics.

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Section: Discussionmentioning

confidence: 99%

Implementation of a nurse-delivered intravitreal injection service

DaCosta

Hamilton

Nago

et al. 2014

Eye

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“…Of the mere total of 103 ophthalmologists for a population of 8.075 million in Honduras, a large majority serve within urban cities, and it is not known how many actively perform eye surgeries. 6,7 Additionally, owing to rural healthcare barriers, many rural dwellers have severe and uncontrolled hypertension and diabetes; consequently, outreach programs, including one run by ZOE Eye Clinic in Tegucigalpa, Honduras, often deny these patients candidacy for subsidized cataract surgeries due to increased surgical and post-operational concerns. [7][8][9] Thus, uncontrolled diabetes and cardiovascular risks, such as hypertension, compound harm for eye health; not only do they increase the likelihood of cataract development, they also hinder patients from receiving surgery.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional analysis of patient-reported awareness, management, and understandings of diabetes and hypertension among cataract patients in rural southern Honduran communities

King

2017

Int J Community Med Public Health

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Background: In Honduras, the prevalence of cataracts, the leading cause of blindness, is rapidly mounting as associated chronic conditions, diabetes and hypertension, are on the rise. The increased demand for cataract surgeries has had the most severe impact on rural communities, as the majority of ophthalmologists serve cities. Additionally, owing to rural healthcare barriers, many rural dwellers have uncontrolled hypertension and diabetes, and consequently, are denied surgical candidacy due to increased surgical risk. Thus, this investigation aims to curb chronic illness in rural Honduran cataract patients by evaluating patient-reported prevalence, management, and local understandings of diabetes and hypertension in the context of socioeconomic data. Methods: The responses of cataract patients to a poverty scorecard and survey questionnaire were categorized and evaluated according to guidelines in the surrounding literature. Height, weight, blood pressure and glucose levels were also measured for each participant. Results: 22.0% and 53.7% of all study participants (n=82) were hyperglycemic and hypertensive respectively. Of the hyperglycemic patients, 38.9% had never been diagnosed with diabetes, while the remaining 61.1% appeared to have mismanaged blood glucose levels. 50% of the hypertensive patients had never been diagnosed with hypertension, and the other 50% appeared to have mismanaged blood pressure. More than half of all participants exhibited only a minimal understanding of diabetes and hypertension. Conclusions: Rural Honduran communities would benefit from regular health screenings and follow-up visits from local doctors. It is important for community health workshops to focus on informing individual health management practices and chronic illness prevention strategies.

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“…[12] For instance, in 2012, the number of ophthalmologists per million population is 112 in France, 81 in Germany, and 99 in Switzerland. [13] Despite its apparent advantage due to its speed and ease of application, this approach often does not consider factors such as productivity, utilization, and distribution of healthcare personnel, making interpretation of the results difficult. Therefore, the problem of unequal distribution of healthcare workforce is likely to persist even with the projected estimates.…”

Section: Health Workforce Forecasting Approachesmentioning

confidence: 99%

Comparing health workforce forecasting approaches for healthcare planning: The case for ophthalmologists

Ansah

Koh

Korne

et al. 2017

IJH

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Health workforce planning is essential in the provision of quality healthcare. Several approaches to planning are customarily used and advocated, each with unique underlying assumptions. Thus, a thorough understanding of each assumption is required in order to make an informed decision on the choice of forecasting approach to be used. For illustration, we compare results for eye care requirements in Singapore using three established workforce forecasting approaches -workforce-to-population-ratio, needs based approach, utilization based approach -and a proposed robust integrated approach to discuss the appropriateness of each approach under various scenarios. Four simulation models using the systems modeling methodology of system dynamics were developed for use in each approach. These models were initialized and simulated using the example of eye care workforce planning in Singapore, to project the number of ophthalmologists required up to the year 2040 under the four different approaches. We found that each approach projects a different number of ophthalmologists required over time. The needs based approach tends to project the largest number of required ophthalmologists, followed by integrated, utilization based and workforce-to-population ratio approaches in descending order. The four different approaches vary widely in their forecasted workforce requirements and reinforce the need to be discerning of the fundamental differences of each approach in order to choose the most appropriate one. Further, health workforce planning should also be approached in a comprehensive and integrated manner that accounts for developments in demographic and healthcare systems.

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The number of ophthalmologists in practice and training worldwide: a growing gap despite more than 200 000 practitioners

Cited by 323 publications

References 1 publication

Implementation of a nurse-delivered intravitreal injection service

Implementation of a nurse-delivered intravitreal injection service

A cross-sectional analysis of patient-reported awareness, management, and understandings of diabetes and hypertension among cataract patients in rural southern Honduran communities

Comparing health workforce forecasting approaches for healthcare planning: The case for ophthalmologists

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