In U.S. states, most counties lack eye care providers, and where they reside there are differences with respect to distribution and practice patterns, according to the findings of a study presented by Ravi Pandit, MD, MPH, at the 37th ASRS Annual Meeting
Despite the increased burden of retinal disease in the US, the distribution and practice patterns of different types of retina providers—as well as the factors that influence—have not been well studied. In this retrospective, cross-sectional study, the researchers used a 2016 Medicare dataset to identify ophthalmologists who performed anti- vascular endothelial growth factor (VEGF) injections. The dataset was subsequently merged with IRS, Census Bureau, and CDC sets to classify county-level income, age distribution, and diabetes burden. In total, 3,002 retina providers, including 2,025 retina specialists, and 977 comprehensive ophthalmologists performing anti-vascular endothelial growth factor (VEGF) injections were identified. All key statistical endpoints were assessed using multivariate logistic regression, chi-square, and two-tailed t-tests. Geospatial analyses were also performed
The findings showed that 12% and 20% of US counties had a retina specialist or retina provider, respectively, compared to 35% for comprehensive ophthalmologists (P<0.001). In comparison to hybrid providers, retina specialists were more likely to practice in the South Atlantic Region of the US (OR=1.84, P<0.01) and in higher income areas (OR=1.28 per quartile, P<0.001), and higher population (OR=1.55 per quartile, P<0.001). Retina specialists were less likely to practice in the Pacific, West North Central, and West South-Central regions (OR=0.40, 0.58, and 0.64, P<0.05 for each region) or in countries who have an older population (OR=0.95 per percentage population older than 55 years, P<0.001). Moreover, there was a negative correlated found between diabetic burden and presence of any retina provider (OR=0.96 per percentage increase in diabetes prevalence, P=0.01). Furthermore, hybrid providers more likely to use bevacizumab than retina specialists (18.6% vs. 12.5%, P<0.001).
Pandit R. Distribution and Practice Patterns of Retina Providers Across the US. Presented at the 37th ASRS Annual Meeting; July 26-30, 2019; Chicago, IL.