Bascom Palmer Eye Institute, University of Miami Health System.
Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami.
J Glaucoma. 2020 Dec;29(12):1147-1151. doi: 10.1097/IJG.0000000000001648. Epub 2020 Sep 3.
Approximately 1 in 9 Florida residents over the age of 65 years (438,642 people) live more than an hour away from a glaucoma specialist, which represents a significant barrier to care.
To describe access to glaucoma care for Florida's elderly population using travel time to American Glaucoma Society (AGS) member offices.
For this cross-sectional service coverage analysis, a list of AGS member locations was extracted from the AGS website, and addresses were geocoded using ArcGIS Online. Driving time regions were created using the service area tool in ArcGIS Pro 2.4 and overlaid with 2010 United States Census and 2016 American Community Survey data for all Florida residents age 65 or older.
Fifty-eight AGS member providers with 65 locations were identified and geocoded. There were 3,797,625 individuals aged over 65 years in Florida, of which 1,153,320 (30.4%) lived within 15 minutes of driving time from an AGS provider's office, 2,586,825 (68.1%) within 30 minutes, 3,358,983 (88.4%) within 60 minutes, and 3,491,815 (91.9%) within 120 minutes. The areas with the lowest access include rural areas near Lake Okeechobee and the Florida Panhandle. The population living beyond a 60-minute drive was more likely to be White, non-Hispanic and older, but less likely to be living below the federal poverty level or receiving public assistance than the population living within a 60-minute drive.
There is a significant travel burden for the elderly community of Florida to reach AGS providers. Additional studies could help identify other social barriers to accessing glaucoma providers in Florida and beyond in an effort to improve patient compliance and, ultimately, vision outcomes.
在佛罗里达州，65 岁以上的居民中，约有 1/9（438642 人）居住在距离青光眼专家一个小时以上的地方，这对他们的治疗造成了很大的障碍。
使用前往美国青光眼学会 (AGS) 成员办公室的旅行时间，描述佛罗里达州老年人群的青光眼护理可及性。
在这项横断面服务覆盖范围分析中，从 AGS 网站上提取了 AGS 成员所在地的列表，并使用 ArcGIS Online 对地址进行地理编码。使用 ArcGIS Pro 2.4 中的服务区域工具创建驾驶时间区域，并将其与 2010 年美国人口普查和 2016 年美国社区调查数据叠加，以获取所有佛罗里达州 65 岁或以上的居民。
确定并地理编码了 58 名 AGS 成员提供者的 65 个地点。佛罗里达州有 3797625 名 65 岁以上的人，其中 1153320 人（30.4%）居住在距离 AGS 提供者办公室 15 分钟车程内，2586825 人（68.1%）居住在 30 分钟车程内，3358983 人（88.4%）居住在 60 分钟车程内，3491815 人（91.9%）居住在 120 分钟车程内。可及性最低的地区包括奥基乔比湖和佛罗里达狭长地带附近的农村地区。居住在 60 分钟车程以外的人群更可能是白人、非西班牙裔和老年人，但比居住在 60 分钟车程内的人群更不可能生活在联邦贫困线以下或接受公共援助。
佛罗里达州的老年人群前往 AGS 提供者处存在很大的交通负担。进一步的研究可以帮助确定在佛罗里达州及其他地区获得青光眼提供者的其他社会障碍，以提高患者的依从性，最终改善视力结果。
