Patient Accessibility to Eye Care in the United States

Ophthalmology 2023;130:354-360

中文摘要

這篇文章研究了在眼科提供者（Eye care providers, ECPs）中是否可以應用醫療保健供應短缺區域（Health Provider Shortage Areas, HPSAs），並研究了HPSA得分與視力損失和ECP密度之間的相關性。研究發現，HPSA得分與視覺障礙（Visual impairment, VI）（r = 0.38，P <0.0001）和ECP密度每個郡人口（r = e0.18，P <0.0001）之間存在統計上顯著但較弱的相關性。多變量回歸分析發現，在鄉村縣（adjusted odds ration [aOR]，2.47；confident interval[CI]，1.93-3.67；P <0.001）和具有不到高中教育程度的居民的流行病（aOR，1.21；95％ CI，1.19-1.25；P <0.001），65歲以上的居民（aOR，1.10；95％ CI，1.07-1.13；P <0.001）和未投保的居民（aOR，1.04；95％ CI，1.01-1.06；P <0.001）的郡中，ECP PAS（cid：2）75th百分位數（可及性較差）的機率更高。目前HPSAs，與ECP相關性薄弱。本研究提出了一種新的方法來識別有高度需求但ECP卻有限的縣市

English Abstract

The article examines whether Health Provider Shortage Areas (HPSAs) can be used to identify areas of eye care provider (ECP) shortage in the United States. The study found a weak correlation between HPSA scores and visual impairment and ECP density per county population. A new scoring system for patient accessibility to ECPs was modeled, which found a higher odds of ECP shortage in rural counties and counties with a greater prevalence of residents with less than a high school education, residents aged 65 years or older, and uninsured residents. The study emphasizes the importance of equitable and proportional patient accessibility to eye care services, especially as the number of visually impaired people in the US is expected to double by 2050. The study also identifies potential areas for improvement in eye care accessibility and recommends extending ECP coverage and improving eye education. The study uses sophisticated geographic information systems analysis to identify counties with ECP shortage and suggests potential policies to address this issue.