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  • Disparities in Access to Oculofacial Plastic Surgeons Are Seen Throughout the US

    Comprehensive Ophthalmology, Oculoplastics/Orbit

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    Review of: Socioeconomic disparities associated with access to oculofacial plastic surgeons: A cross-sectional analysis of US county demographics

    Paramo R, Zong A, Barmettler A. Ophthalmology, April 2024

    In the United States (US), there is a wide range of county-by-country distribution of oculofacial plastic surgeons (OPS), leading to gaps in access to this specialized ophthalmic care.

    Study Design

    The “Find an Ophthalmologist” tool on the Academy website and the “Find a Surgeon” tool on the American Society of Ophthalmic Plastic and Reconstructive Surgeons website were used to identify US OPS distribution (as of September 2023). Population demographic and socioeconomic data were obtained from the 2021 US Census Bureau Population Estimates Program and the 2017–2021 American Community Survey, while the 2022 Economic Policy Institute Family Budget Calculator provided information on the estimated annual cost of living per person. US counties were divided into those with no OPS and those with ≥1 OPS.

    Outcomes

    The average number of OPS in the US was estimated to be 3.5 per million people. Counties with no OPS were more likely to have an older population, lower household income and cost of living, lower rate of Internet access, and lower educational level. A greater number of residents of these counties either had no insurance or only Medicare/Medicaid than residents of counties with ≥1 OPS.

    Limitations

    The data collection methods used in this study may not have yielded the actual number or location of OPS. Also, there may be an underestimation of health care disparities, because data extracted from the US Census Bureau excludes undocumented immigrants and international patients who face barriers to accessing health care due to immigration status, lack of insurance coverage, educational level, or financial constraints.

    Clinical Significance

    When appropriate, OPS should consider offering telemedicine services to be able to reach a wider patient population. OPS should also consider establishing relationships with community primary care providers and practice-related specialties, such as endocrinologists, to improve awareness of what OPS can provide. Additionally, OPS should ensure that their demographic information is up to date.

    Financial Disclosures: Dr. Nikisha Richards discloses financial relationships with Genentech and Horizon Therapeutics (Consultant/Advisor).