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A Comparative Analysis of the Economic and Workforce Issues in Pediatric Ophthalmology in Italy and the United States
Laurel Lam1, Leonard B Nelson1, Aldo Vagge2
1The Department of Pediatric Ophthalmology and Strabismus, Wills Eye Hospital, Philadelphia, Pennsylvania.
Purpose:
To present a comparative analysis of the economic and workforce issues impacting access to pediatric ophthalmology care in Italy and the United States in the post-pandemic era.
Methods:
Data collection for this cross-sectional study occurred between August 2023 and July 2024, using publicly available workforce and demographic data to calculate supply-demand (provider-patient) ratios. Additionally, qualitative data were obtained through a structured questionnaire distributed to fellowship-trained pediatric ophthalmologists in Italy.
Results:
The provider-patient ratio was 1:69,700 in the United States and approximately 1:445,000 in Italy, reflecting significant workforce shortages in both countries, with a greater deficit observed in Italy. Contributing factors in Italy include the absence of a formal fellowship training program, inadequate reimbursement, and a reduction in critical resources and facilities. In the United States, similar challenges have been exacerbated by the coronavirus disease 2019 (COVID-19) pandemic, resulting in reduced practice viability, limited surgical training, and declining interest in the sub-specialty among trainees.
Conclusions:
Although health care infrastructures differ between Italy and the United States, the long-standing crisis in Italy may serve as a cautionary model for the potential trajectory of pediatric ophthalmology in the United States should current trends persist. Without strategic interventions to improve workforce retention and training, both countries remain at risk for erosion of access to timely and equitable pediatric ophthalmic care.
