Lieu Alexander C, Chuter Benton G, Radgoudarzi Niloofar, Walker Evan H, Huang John H, Scott Nathan L, Afshari Natalie A
School of Medicine, University of California San Diego, La Jolla, CA, USA.
Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, CA, USA.
Clin Ophthalmol. 2024 Sep 3;18:2487-2502. doi: 10.2147/OPTH.S472064. eCollection 2024.
To study geographic patterns of supply and demand for uveal melanoma and other ocular oncology healthcare by ocular oncology physicians in the United States.
Google search interest data was obtained through trends.google.com. The combined-state density of ocular oncology physicians was calculated by dividing the number of practicing ocular oncologists in each state and its surrounding states by the state population. Relative search volume (RSV) values were divided by ocular oncology physician density to calculate the Google relative demand index (gRDI) for each state. Medicare (mRDI) and IRIS Registry (iRDI) relative demand indices were calculated using prevalence data obtained through the Vision and Eye Health Surveillance System (VEHSS). Data from the US Census Bureau and Centers for Disease Control (CDC) databases were also utilized to analyze associations with poverty rates, percent living in urban or rural areas, vision screening rates, and ocular neoplasm rates.
Alabama showed the highest RSV (100), while the lowest was reported in New Mexico (20). Vermont had the highest density of combined-state ocular oncology ophthalmologists (1.85 per 100,000 residents). New Mexico had the lowest RDI (0.013 gRDI, 0.015 mRDI, 0.018 iRDI) with 32 combined-state ocular oncologists and a population of 2,114,371. Ocular neoplasm prevalence rates ranged between 1.32% and 5.40% and significantly correlated with RSV. Single-state gRDI correlated with rural status and negatively correlated with urban areas (≥50,000 individuals). Single-state ophthalmologist density correlated positively with percent living in urban areas and vision screening rates, and negatively with rural status.
This study uncovered significant heterogeneity in the geographical distribution of ocular oncology physicians and RDI throughout the United States, highlighting potential undersupply scenarios. This may guide efforts to increase ocular oncology physician and surgeon availability in areas of need.
研究美国葡萄膜黑色素瘤及其他眼部肿瘤医疗保健的供需地理模式。
通过trends.google.com获取谷歌搜索兴趣数据。通过将每个州及其周边州执业的眼科肿瘤医生数量除以该州人口来计算眼科肿瘤医生的合并州密度。相对搜索量（RSV）值除以眼科肿瘤医生密度，以计算每个州的谷歌相对需求指数（gRDI）。使用通过视力与眼健康监测系统（VEHSS）获得的患病率数据计算医疗保险（mRDI）和虹膜登记处（iRDI）相对需求指数。还利用美国人口普查局和疾病控制中心（CDC）数据库的数据来分析与贫困率、城乡居住百分比、视力筛查率和眼部肿瘤发生率的关联。
阿拉巴马州的RSV最高（100），而新墨西哥州最低（20）。佛蒙特州合并州眼科肿瘤眼科医生的密度最高（每10万居民中有1.85人）。新墨西哥州的RDI最低（0.013 gRDI，0.015 mRDI，0.018 iRDI），有32名合并州眼科肿瘤医生，人口为2,114,371。眼部肿瘤患病率在1.32%至5.40%之间，与RSV显著相关。单州gRDI与农村状况相关，与城市地区（≥50,000人）呈负相关。单州眼科医生密度与城市居住百分比和视力筛查率呈正相关，与农村状况呈负相关。
本研究揭示了美国眼科肿瘤医生和RDI地理分布的显著异质性，突出了潜在的供应不足情况。这可能有助于指导在需求地区增加眼科肿瘤医生和外科医生的可及性。
