Xue Katie, Feng Yilin, Tam Vicky, Lin Chun Chieh, De Lott Lindsey B, Hamedani Ali G
Departments of Neurology and Ophthalmology (KX, AGH), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Ophthalmology (YF), Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; Department of Biomedical and Health Informatics (VT), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Neurology (CCL, LBDL), University of Michigan Medical School, Ann Arbor, Michigan; Department of Ophthalmology and Visual Sciences (LBDL), Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; Leonard Davis Institute for Health Economics (AGH), University of Pennsylvania, Philadelphia, Pennsylvania.
J Neuroophthalmol. 2023 Jun 1;43(2):149-152. doi: 10.1097/WNO.0000000000001821. Epub 2023 Mar 1.
Neuro-ophthalmologists have expertise in rare and complex disorders, but the ability of patients to access neuro-ophthalmic care has not been examined at a nationwide level.
Using the 2020 directory of all 502 members of the North American Neuro-Ophthalmology Society as a reference, we found the practice locations of 461 confirmed practicing members and converted each street address to latitude and longitude coordinates. We calculated the travel distance and time from each census tract to the nearest practice location and calculated population-weighted averages by state, region, and other prespecified factors. Choropleth maps were used to visualize the distribution of travel distances and times across the United States.
California had the most practicing neuro-ophthalmologists out of any state (50), whereas 4 states (DE, MT, SD, and WY) had none. Washington, DC and MA had the most neuro-ophthalmologists per capita. The average travel distance and time to the nearest neuro-ophthalmologists were found to be 40.90 miles and 46.50 minutes, respectively, although a large portion of western plains and mountain regions had travel times of over 120 minutes. Patients in rural areas had longer travel times than those in urban areas, and Native American patients had the longest travel times of any racial or ethnic group.
The travel time to see a neuro-ophthalmologist varies widely by state, region, and rurality, with Native American patients and rural patients being disproportionately affected. By identifying the areas with the greatest travel burdens, future policies can work to alleviate these potential barriers to care.
神经眼科医生在罕见和复杂疾病方面具有专业知识，但患者获得神经眼科护理的能力尚未在全国范围内得到研究。
以北美神经眼科学会502名成员的2020年名录为参考，我们找到了461名确认执业成员的执业地点，并将每个街道地址转换为经纬度坐标。我们计算了每个普查区到最近执业地点的旅行距离和时间，并按州、地区和其他预先指定的因素计算了人口加权平均值。使用分级统计图来可视化美国各地旅行距离和时间的分布。
加利福尼亚州的执业神经眼科医生数量在所有州中最多（50名），而有4个州（特拉华州、蒙大拿州、南达科他州和怀俄明州）没有。华盛顿特区和马萨诸塞州的人均神经眼科医生数量最多。到最近的神经眼科医生处就诊的平均旅行距离和时间分别为40.90英里和46.50分钟，不过西部平原和山区的很大一部分地区旅行时间超过120分钟。农村地区的患者比城市地区的患者旅行时间更长，美国原住民患者的旅行时间在所有种族或族裔群体中最长。
看神经眼科医生的旅行时间因州、地区和农村地区而异，美国原住民患者和农村患者受到的影响尤为严重。通过确定旅行负担最大的地区，可以制定未来政策来缓解这些潜在的护理障碍。
