Geographic Distribution of US Ophthalmic Surgical Subspecialists

Area of Science:

• Ophthalmology
• Health Services Research
• Rural Health

Background:

• Urban areas have more ophthalmologists than rural areas, but the distribution of ophthalmic surgical subspecialists is not well understood.
• A potential shortage of rural subspecialists could disproportionately affect the care burden for rural patients.

Purpose of the Study:

• To analyze the geographic distribution of ophthalmic surgical subspecialists.
• To identify factors associated with subspecialists practicing in rural locations.

Main Methods:

• A cross-sectional, population-based study analyzed Medicare Fee-for-Service claims from 2012-2022.
• Data included 1,619,043 ophthalmic procedures performed by 13,526 subspecialists (cornea, glaucoma, oculoplastic, retina, strabismus).

Main Results:

• 17.4% of patients resided in rural areas, compared to only 5.6% of subspecialist surgeons.
• Female surgeons (aOR 0.63), those in the Northeast and West, and recent graduates were less likely to practice rurally.
• Rural surgeon numbers decreased over the study period.

Conclusions:

• A notable disparity exists between the proportion of rural patients and rural ophthalmic subspecialist surgeons.
• Factors such as surgeon gender and graduation year influence rural practice location.
• This maldistribution may create challenges in accessing specialized ophthalmic care for rural populations.