Unanswered Questions Pertaining to the Economic and Workforce Issues in Pediatric Ophthalmology

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

doi:10.3928/01913913-20230213-02

Cited by 4 publications

References 10 publications

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Assessing The Relationship Between Demand And Accessibility For Pediatric Ophthalmology Services By State In The United States

Chuter,

Lieu,

Huynh

et al. 2024

Preprint

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PurposeTo investigate the relationship between public demand for pediatric ophthalmology services and the accessibility of such services on a statewide basis in the United States, focusing on strabismus care.MethodsUsing Google Trends data, search volumes for “strabismus” were analyzed from January 2014 to December 2023. Pediatric ophthalmologist availability was assessed via the American Academy of Ophthalmology directory, normalized for state population size to create a relative demand index. Additional metrics from the United States Census Bureau and Centers for Disease Control and Prevention provided socioeconomic and health data. Correlation coefficients were used to explore relationships between search volumes, specialist availability, vision screening, socioeconomics, and demographic factors.ResultsThe data revealed variability in public interest in pediatric ophthalmology across states, with Alaska showing the highest relative search volume for strabismus. The data also indicated notable disparities in pediatric ophthalmologist density, with North Dakota, Vermont, and Wyoming having no pediatric ophthalmologists. A significant correlation was identified between pediatric ophthalmologist availability and vision screening (R = 0.486, p < 0.001). Negative correlations were observed between the relative demand index and urbanization (R = −0.388, p = 0.007), as well as the strabismus prevalence (R = −0.455, p = 0.001), indicating that urbanization and specialist distribution influence eyecare demand and access.ConclusionThe findings highlight disparities in accessibility and demand for pediatric ophthalmology services across the US, influenced by urbanization and distribution of healthcare professionals. The study underscores the need for targeted interventions to improve access to care and bridge gaps in pediatric ophthalmology service provision.

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Assessing The Relationship Between Demand And Accessibility For Pediatric Ophthalmology Services By State In The United States

Chuter,

Lieu,

Huynh

et al. 2024

Preprint

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The Medicaid Dilemma and Its Profound Effect on the Economic and Workforce Issues in Pediatric Ophthalmology and Ultimately on Access to Pediatric Eye Care

Lee¹,

Sussberg²,

Nelson³

et al. 2023

J Pediatr Ophthalmol Strabismus

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Purpose: To identify new patient, follow-up, and surgery appointment wait times for children seeking care at academic eye centers/children's hospitals (AEC/CHs) in the setting of very low Medicaid reimbursements and workforce issues in pediatric ophthalmology. Methods: Each state in the United States with AEC/CHs was contacted by phone or email. Using a standardized script, the authors inquired about approximate wait times for non-emergency new patient, follow-up, and surgery appointment times, as well as percentage of patients insured by Medicaid seen at the AEC/CH. Medicaid reimbursements for new patient visits, follow-up visits, sensorimotor examinations, and one-muscle strabismus surgery were examined for each state. Results: The mean percentage of children enrolled in Medicaid across the United States was 38.0%. Appointment and Medicaid inquiry calls were conducted across 41 states. Mean wait times across the United States for new patient, follow-up, and surgery appointments were 3.9, 3.4, and 2.7 months, respectively. Mean percentage of patients insured by Medicaid at AEC/CHs was 57.1%. High Medicaid-insured states offered longer wait times for new patient appointments than low Medicaid-insured states (4.4 versus 3.5 months; P = .20). The lowest Medicaid reimbursements for new patient visit, follow-up visit, sensorimotor examination, and one-muscle strabismus surgery occurred in Illinois, California, Ohio, and Michigan, respectively. Conclusions: Across the United States, states with higher percentages of patients insured by Medicaid exhibited longer new patient appointment wait times, suggesting that challenges related to Medicaid reimbursements directly contribute to disparities in access to pediatric eye care. [ J Pediatr Ophthalmol Strabismus . 2023;60(3):170–177.]

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What We Learned About the Economic and Workforce Issues in Pediatric Ophthalmology: Access to Eye Care and Possible Solutions

Lee,

Sussberg,

Nelson

et al. 2023

J Pediatr Ophthalmol Strabismus

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Purpose: To provide a blueprint reviewing the major economic and workforce issues in pediatric ophthalmology and its effect on access to pediatric eye care, as well as potential solutions. Methods: This was a systematic review of the landmark studies examining the economic and workforce issues in pediatric ophthalmology was performed. Results: The number of residents pursuing pediatric ophthalmology fellowship has steadily declined since the early 2000s. Increasing overhead costs, low Medicaid reimbursements, practice pattern changes, and workforce shortages have all contributed to a significant crisis in access to pediatric eye care. Conclusions: Solutions to improve access to pediatric eye care involve pursuing more economical strategies within the confines of the pediatric ophthalmology practice, early exposure to the field during medical education, and enhancing residents' interest through faculty mentorship. Low reimbursements are a major driver contributing to extended appointment wait times for pediatric ophthalmology visits at major academic eye centers. Legislative changes at both the federal and state levels are needed to make appropriate increases in reimbursements, starting with states in the lowest quartile of Medicaid reimbursements. [ J Pediatr Ophthalmol Strabismus . 2023;60(5):323–329.]

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Unanswered Questions Pertaining to the Economic and Workforce Issues in Pediatric Ophthalmology

Cited by 4 publications

References 10 publications

Assessing The Relationship Between Demand And Accessibility For Pediatric Ophthalmology Services By State In The United States

Assessing The Relationship Between Demand And Accessibility For Pediatric Ophthalmology Services By State In The United States

The Medicaid Dilemma and Its Profound Effect on the Economic and Workforce Issues in Pediatric Ophthalmology and Ultimately on Access to Pediatric Eye Care

What We Learned About the Economic and Workforce Issues in Pediatric Ophthalmology: Access to Eye Care and Possible Solutions

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