Yadlapalli Nikhita, Hollinger Ruby, Berzack Shannan, Spies Daniela, Patel Annika, Sridhar Jayanth
Florida International University Herbert Wertheim College of Medicine, Miami.
Baylor College of Medicine, Houston, Texas.
JAMA Ophthalmol. 2024 Sep 19;142(11):1018-26. doi: 10.1001/jamaophthalmol.2024.3569.
Federally qualified health centers (FQHCs) are federally funded community health clinics that provide comprehensive care to underserved populations, making them potential opportunities to offer eye care and address unmet health care needs. Evaluating the presence of eye care services at FQHCs in Florida is important in understanding and addressing possible gaps in care for the state's large uninsured and underserved populations.
To determine whether FQHCs in Florida are currently offering eye care services, where they are available, what services are being offered, and who provides them.
DESIGN, SETTING, AND PARTICIPANTS: This study used a cross-sectional design conducted within 1 year (from November 2023 to February 2024). FQHCs listed in the US Health Resources and Services Administration database were contacted by telephone to inquire about the presence of eye care services. The FQHCs were located in both urban and rural areas in Florida to assess accessibility of eye care services in the state. School-based health centers and nonophthalmic specialty care health centers were excluded. A total of 437 FQHCs were included.
Primary outcomes included the presence of eye care services, types of services offered, clinician type (optometrists or ophthalmologists), frequency of services, and availability of pediatric services.
Among 437 FQHCs contacted, only 39 (8.9%) reported offering eye care services. These services primarily included vision examinations, glasses prescriptions, and dilated eye examinations. Optometrists were the primary providers of services at all clinics, with no clinics reporting care by ophthalmologists. The frequency of services varied considerably, ranging from daily to bimonthly. Thirty-seven (94.9%) of the 39 clinics offered pediatric eye care services.
The low prevalence of FQHCs with eye care services and the absence of ophthalmologist-provided care highlight a gap in access to eye care for underserved populations in Florida. These findings support investigations into implementing eye care services and interventions at FQHCs that might enhance access and equity in eye care.
联邦合格健康中心（FQHCs）是由联邦政府资助的社区健康诊所，为服务不足的人群提供全面护理，使其成为提供眼科护理和满足未得到满足的医疗保健需求的潜在机会。评估佛罗里达州FQHCs的眼科护理服务情况，对于了解和解决该州大量未参保和服务不足人群在护理方面可能存在的差距至关重要。
确定佛罗里达州的FQHCs目前是否提供眼科护理服务、服务地点、提供哪些服务以及由谁提供这些服务。
设计、设置和参与者：本研究采用横断面设计，在1年内（从2023年11月至2024年2月）进行。通过电话联系美国卫生资源与服务管理局数据库中列出的FQHCs，询问其是否有眼科护理服务。FQHCs分布在佛罗里达州的城市和农村地区，以评估该州眼科护理服务的可及性。排除了校内健康中心和非眼科专科护理健康中心。共纳入437家FQHCs。
主要结局包括是否存在眼科护理服务、提供的服务类型、临床医生类型（验光师或眼科医生）、服务频率以及儿科服务的可及性。
在联系的437家FQHCs中，只有39家（8.9%）报告提供眼科护理服务。这些服务主要包括视力检查、眼镜处方和散瞳眼科检查。所有诊所的服务主要由验光师提供，没有诊所报告由眼科医生提供护理。服务频率差异很大，从每天到每两个月不等。39家诊所中有37家（94.9%）提供儿科眼科护理服务。
提供眼科护理服务的FQHCs比例较低，且缺乏眼科医生提供的护理，这凸显了佛罗里达州服务不足人群在获得眼科护理方面存在的差距。这些发现支持对在FQHCs实施眼科护理服务和干预措施进行调查，这可能会提高眼科护理的可及性和公平性。
