RESUMEN
AIM: The aim of this study was to update and project the growth of ophthalmologists in New Zealand. This will help decision makers better understand the current ophthalmologist workforce and make appropriate resource allocations. METHOD: Supply and demographics of ophthalmologists in New Zealand were obtained from the Medical Council of New Zealand, Health Workforce New Zealand and Health New Zealand - Te Whatu Ora. Ophthalmology trainee numbers were extracted from the annual reports of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). New Zealand population statistics were extracted from the Stats NZ database. A simulation model was developed to project the growth of ophthalmologists from 2024 to 2050. RESULTS: In March 2023, there were 175 practising ophthalmologists in New Zealand. Overall, there were 34.0 ophthalmologists per million population, with 201.4 ophthalmologists per million for those aged ≥65 years. To maintain the current ratio, an additional 20 practising ophthalmologists are needed by 2050. CONCLUSION: The ratio of ophthalmologists per million population aged ≥65 years is projected to drop by 1.5% annually. To meet the demand of an increasing and ageing population, and RANZCO's goal of 40 ophthalmologists per million population, there needs to be an increase in ophthalmologist training positions from the current 5-year average of 6.6 to 11 new trainees annually, and a more effective distribution of the ophthalmologist workforce.
Asunto(s)
Oftalmólogos , Oftalmología , Nueva Zelanda , Humanos , Oftalmólogos/estadística & datos numéricos , Oftalmólogos/provisión & distribución , Oftalmología/educación , Oftalmología/estadística & datos numéricos , Predicción , Anciano , Fuerza Laboral en Salud/tendencias , Fuerza Laboral en Salud/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Femenino , Adulto , Recursos Humanos/estadística & datos numéricosRESUMEN
PURPOSE: To provide an update of cataract as a cause of vision loss in Latin America and to analyze sex inequalities in cataract surgical coverage (CSC) and effective CSC (eCSC) in the region. DESIGN: Population-based systematic review with longitudinal comparisons. METHODS: The Latin American and Caribbean Health Sciences Literature (LILACS) and PubMed databased were searched for population-based studies reporting cataract blindness, surgical coverage, and outcomes published between January 2014 and December 2019. Information on the number of surgeries performed from the 2014-2016 period was obtained from ministries of health and was used for calculation of the cataract surgical rate (CSR). Sources such as Rapid Assessment of Avoidable Blindness (RAAB) and Rapid Assessment of Cataract Surgical Services data were reanalyzed to calculate sex inequality in CSC and eCSC by subtracting the rate in women from the rate in men. RESULTS: Cataract was the cause of 29.8%-77.6% of cases of blindness in the included studies; the CSR improved in 10 countries. The CSC pinhole visual acuity of 3/60 varied from 24.1% in Peru to 97.1% in Argentina, and the median absolute gender inequality CSC pinhole visual acuity 3/60 was -0.7%. The eCSC pinhole visual acuity 3/60 varied from 14.8% in Guatemala to 92.1% in Argentina, and the median absolute gender inequality eCSC pinhole visual acuity 3/60 was -0.8%. CONCLUSIONS: Cataract remains a leading cause of blindness in Latin America. Coverage is suboptimal, and surgical results are also below target levels in many countries. Incentives for a better distribution of human resources, adequate training of ophthalmologists, and the inclusion of vision services in universal health care coverage could reduce the burden of cataract in Latin America.
Asunto(s)
Ceguera/etiología , Extracción de Catarata/estadística & datos numéricos , Catarata/complicaciones , Baja Visión/etiología , Ceguera/epidemiología , Catarata/epidemiología , Atención a la Salud , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Disparidades en Atención de Salud , Humanos , América Latina/epidemiología , Oftalmólogos/educación , Oftalmólogos/estadística & datos numéricos , Oftalmólogos/provisión & distribución , Baja Visión/epidemiologíaAsunto(s)
Oftalmólogos/estadística & datos numéricos , Médicos Mujeres/estadística & datos numéricos , Concienciación , Femenino , Humanos , Internado y Residencia/estadística & datos numéricos , Liderazgo , Masculino , Oftalmólogos/provisión & distribución , Oftalmología/educación , Ejecutivos Médicos/estadística & datos numéricos , Médicos Mujeres/provisión & distribución , Factores SexualesRESUMEN
Retinopathy of prematurity (ROP) is the leading cause of childhood blindness in very-low-birthweight and very preterm infants in the United States. With improved survival of smaller babies, more infants are at risk for ROP, yet there is an increasing shortage of providers to screen and treat ROP. Through a literature review of new and emerging technologies, screening criteria, and analysis of a national survey of pediatric ophthalmologists and retinal specialists, the authors found the shortage of ophthalmology workforce for ROP a serious and growing concern. When used appropriately, emerging technologies have the potential to mitigate gaps in the ROP workforce.
Asunto(s)
Inteligencia Artificial , Oftalmólogos/provisión & distribución , Retinopatía de la Prematuridad/diagnóstico , Retinopatía de la Prematuridad/terapia , Telemedicina , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Tamizaje Neonatal , Encuestas y Cuestionarios , Estados UnidosRESUMEN
BACKGROUND/AIMS: To estimate 2015 global ophthalmologist data and analyse their relationship to income groups, prevalence rates of blindness and visual impairment and gross domestic product (GDP) per capita. METHODS: Online surveys were emailed to presidents/chairpersons of national societies of ophthalmology and Ministry of Health representatives from all 194 countries to capture the number and density (per million population) of ophthalmologists, the number/density performing cataract surgery and refraction, and annual ophthalmologist population growth trends. Correlations between these data and income group, GDP per capita and prevalence rates of blindness and visual impairment were analysed. RESULTS: In 2015, there were an estimated 232 866 ophthalmologists in 194 countries. Income was positively associated with ophthalmologist density (a mean 3.7 per million population in low-income countries vs a mean 76.2 in high-income countries). Most countries reported positive growth (94/156; 60.3%). There was a weak, inverse correlation between the prevalence of blindness and the ophthalmologist density. There were weak, positive correlations between the density of ophthalmologists performing cataract surgery and GDP per capita and the prevalence of blindness, as well as between GDP per capita and the density of ophthalmologists doing refractions. CONCLUSIONS: Although the estimated global ophthalmologist workforce appears to be growing, the appropriate distribution of the eye care workforce and the development of comprehensive eye care delivery systems are needed to ensure that eye care needs are universally met.
Asunto(s)
Salud Global/estadística & datos numéricos , Fuerza Laboral en Salud/estadística & datos numéricos , Oftalmólogos/provisión & distribución , Oftalmología/estadística & datos numéricos , Femenino , Personal de Salud/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Investigación sobre Servicios de Salud , Encuestas Epidemiológicas , Humanos , Renta , Agencias Internacionales , Masculino , Oftalmología/economía , Sociedades Médicas , Encuestas y CuestionariosRESUMEN
BACKGROUND: Highly-competent patient care is paramount to medicine. Quality training and patient accessibility to physicians with a wide range of specializations is essential. Yet, poor quality of life for physicians cannot be ignored, being detrimental to patient care and leading to personnel leaving the medical profession. In 2004, the Japanese government reformed postgraduate training for medical graduates, adding a 2-year, hands-on rotation through different specialties before the specialization residency was begun. Residents could now choose practice location, but it sparked concerns that physician distribution disparities had been created. Japanese media reported that residents were choosing specialties deemed to offer a higher quality of life, like Ophthalmology or Dermatology, over underserved areas like Obstetrics or Cardiology. To explore the consequences of Japan's policy efforts, through the residency reform in 2004, to improve physician training, analyzing ophthalmologist supply and distribution in the context of providing the best possible patient care and access while maintaining physician quality of life. METHODS: Using secondary data, we analyzed changes in ophthalmologist supply at the secondary tier of medical care (STM). We applied ordinary least-squares regression models to ophthalmologist density to reflect community factors such as residential quality and access to further professional development, to serve as predictors of ophthalmologist supply. Coefficient equality tests examined predictor differences before and after 2004. Similar analyses were conducted for all physicians excluding ophthalmologists (other physicians). Ophthalmologist coverage in top and bottom 10% of STMs revealed supply inequalities. RESULTS: Change in ophthalmologist supply was inversely associated with baseline ophthalmologist density before (P < .01) and after (P = .01) 2004. Changes in other physician supply were not associated with baseline other physician density before 2004 (P = 0.5), but positively associated after 2004 (P < .01). Inequalities between top and bottom 10% of ophthalmologist supply in STMs were large, with best-served areas maintaining roughly five times greater coverage than least-served areas. However, inequalities gradually declined between 1998 and 2012. CONCLUSIONS: Ophthalmologist supply increased both before and after the 2004 reform, yet contrary to media reports, proceeded at a lesser rate than supply increases for other physicians. After 2004, geographical disparities decreased for ophthalmologists, while increasing for other physicians.
Asunto(s)
Oftalmólogos/provisión & distribución , Ubicación de la Práctica Profesional , Humanos , Internado y Residencia , Japón , Médicos/provisión & distribución , Calidad de Vida , Especialización , Factores de TiempoRESUMEN
We aimed to determine the distribution of ophthalmic care providers and its correlation with health and socioeconomic status and health system indicators. Data were gathered from the Iran Medical Council and the Iranian Societies of Ophthalmology and Optometry. Concurrent indicators were collected from the Statistical Center of Iran and national studies. A population-adjusted number of combined ophthalmologists and optometrists was used as the main dependent variable. Optometrist/ophthalmologist ratio was 0.9. We had 1 ophthalmologist and 1 optometrist for every 40 000 and 45 000 individuals, respectively. We observed a direct correlation between the number of ophthalmologists, optometrists and life expectancy at the provincial level. Gross provincial income and expenditure and provincial literacy were correlated as well. Provincial unemployment had a negative correlation. Provincial hospital statistics and population density were also significantly correlated. The Islamic Republic of Iran has met the World Health Organization's desired per capita number of ophthalmologists and optometrists, but there is wide variation in their density.
Asunto(s)
Oftalmólogos/provisión & distribución , Optometristas/provisión & distribución , Bases de Datos Factuales , Femenino , Humanos , Irán , Masculino , Oftalmólogos/estadística & datos numéricos , Optometristas/estadística & datos numéricosRESUMEN
BACKGROUND: No comprehensive study currently exists on the supply of ophthalmologists across Latin America. We explored sociogeographic inequalities in the availability and distribution of ophthalmologists across 14 Latin American countries. METHODS: The National Ophthalmologic Societies of Argentina, Bolivia, Brazil, Colombia, Costa Rica, Chile, the Dominican Republic, Ecuador, Guatemala, Mexico, Paraguay, Peru, Uruguay and Venezuela provided data on affiliated ophthalmologists by first-order subnational divisions in 2013. Human Development Index (HDI) estimates at the corresponding subnational division were used as equity stratifiers. Distributional inequality of ophthalmologists within each country was assessed by the health concentration index (HCI) and the index of dissimilarity (ID), along with the mean level of ophthalmologists per population. RESULTS: Across all countries studied, there were 5.2 ophthalmologists per 100â 000 population on average (95% CI 5.0 to 5.4) in 2013, with a mean HCI of 0.26 (0.16 to 0.37) and a mean relative ID of 22.7% (20.9% to 24.7%). There was wide inequality in ophthalmologist availability between countries, ranging from 1.2 (1.1 to 1.4) in Ecuador to 8.6 (8.5 to 8.8) in Brazil. All countries had positive (ie, pro-rich) HCI values ranging from 0.68 (0.66 to 0.71) in Guatemala to 0.02 (-0.11 to 0.14) in Venezuela. Correspondingly, redistributive potential to achieve equity was closest in Venezuela (ID: 1.5%) and farthest in Guatemala (ID: 60.3%). Benchmarked against regional averages, most countries had a lower availability of ophthalmologists and higher relative inequality. CONCLUSIONS: There is high inequality in the level and distribution of ophthalmologists between and within countries in Latin America, with a disproportionate number concentrated in more developed, socially advantaged areas. More equitable access to ophthalmologists could be achieved by implementing incentivised human resources redistribution programmes and by improving the social determinants of health in underserved areas.