Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut.
Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
Am J Ophthalmol. 2020 Oct;218:128-135. doi: 10.1016/j.ajo.2020.05.018. Epub 2020 May 21.
To describe temporal and geographic trends in the US eye care workforce.
Cross-sectional study.
We obtained data from the 2017 Area Health Resources File. The main outcomes were ophthalmologist and optometrist density, as defined as the number of providers per 100,000 individuals, the ratio of ophthalmologists ≥55 years of age to those <55 years of age, and county characteristics associated with the availability of an ophthalmologist.
From 1995 to 2017, the national ophthalmologist density decreased from 6.30 to 5.68 ophthalmologists per 100,000 individuals. Although rural counties experienced a mean annual increase in ophthalmologist density by 2.26%, they still had a lower mean ophthalmologist density (0.58/100,000 individuals) compared with nonmetropolitan (2.19/100,000 individuals) and metropolitan counties (6.29/100,000 individuals) in 2017. The ratio of older to younger ophthalmologists increased from 0.37 in 1995 to 0.82 in 2017, with the greatest ratio increase occurring in rural counties (0.29 to 1.90). The presence of an ophthalmologist was significantly associated with a greater proportion of individuals with a college degree and health insurance, and more developed health care infrastructure. From 1990 to 2017, the density of optometrists increased from 11.06 to 16.16 optometrists per 100,000 individuals.
Over the last 2 decades, the national density of ophthalmologists has decreased and the workforce has aged. In contrast, the density of optometrists has increased. Rural counties continue to have a disproportionately lower supply of eye care providers, although some growth has occurred. Given the rising ratio of optometrists to ophthalmologists, it is of interest for future work to determine how the optometrist workforce can best complement potential shortages of ophthalmologists.
描述美国眼科保健劳动力的时间和地理趋势。
横断面研究。
我们从 2017 年地区卫生资源文件中获取数据。主要结果是眼科医生和视光师的密度，定义为每 10 万人中的提供者人数、≥55 岁的眼科医生与<55 岁的眼科医生的比例以及与眼科医生的可用性相关的县特征。
从 1995 年到 2017 年，全国眼科医生密度从每 10 万人 6.30 名下降到 5.68 名。尽管农村县的眼科医生密度平均每年增加 2.26%，但与非大都市（每 10 万人 2.19 名）和大都市县（每 10 万人 6.29 名）相比，农村县的平均眼科医生密度仍然较低（每 10 万人 0.58 名）。1995 年至 2017 年，较年轻的眼科医生与较年长的眼科医生的比例从 0.37 增加到 0.82，其中农村县的比例增加最大（从 0.29 增加到 1.90）。眼科医生的存在与更多具有大学学历和医疗保险的个体以及更发达的医疗保健基础设施显著相关。从 1990 年到 2017 年，视光师的密度从每 10 万人 11.06 名增加到每 10 万人 16.16 名。
在过去的 20 年中，全国眼科医生的密度下降了，劳动力也老龄化了。相比之下，视光师的密度有所增加。农村县的眼科保健提供者供应仍然不成比例地较低，尽管有所增长。鉴于视光师与眼科医生的比例不断上升，未来的工作有必要确定视光师劳动力如何最好地补充眼科医生的潜在短缺。
