ImportanceInvestigating disparities in service coverage of pediatric optometrists and pediatric ophthalmologists in relation to patient demographics will illuminate vulnerable populations and inform future interventions.ObjectiveTo characterize the geographic distribution of pediatric eye care practitioners and analyze its association with population demographics.Design, Setting, and ParticipantsIn this cross-sectional study, 4 public databases were used to identify the addresses of pediatric optometrists and pediatric ophthalmologists in the US in April 2023. Addresses were geocoded, and population demographic data were collected. Pediatric optometrists and pediatric ophthalmologists listed in the public databases, as well as respondents to the 2020 US census, were included in this study. Data were analyzed from April to July 2023.ExposuresPublic databases and US census data of eye practitioners and their practice locations.Main Outcomes and MeasuresGeographic distribution of pediatric optometrists and pediatric ophthalmologists as listed in public databases and correlations between service coverage and US population demographics.ResultsA total of 586 pediatric optometrists (302 female [51.5%]) and 1060 pediatric ophthalmologists (590 male [55.7%]) were identified. Among US counties, 203 (6.5%) had at least 1 pediatric optometrist, and 308 (9.7%) had at least 1 pediatric ophthalmologist, showing substantial geographic overlap (odds ratio, 12.7; 95% CI, 9.4-17.4; P < .001). In the 2834 counties without pediatric ophthalmologists, 2731 (96.4%) lacked pediatric optometrists. There were more pediatric ophthalmologists per million people (3.3) compared with pediatric optometrists per million people (2.5) across all states (difference, 0.8; 95% CI, 0-1.9; P = .047). Among counties with practitioners, the median (IQR) number of pediatric optometrists per million people was 7.8 (0.4-245.0), surpassing the median (IQR) number of pediatric ophthalmologists per million people, 5.5 (1.0-117.0). Counties with pediatric ophthalmologists had higher mean (SD) household incomes than counties with pediatric optometrists ($76 126.87 [$21 879.23] vs $68 681.77 [$18 336.40]; difference, −$7445.10; 95% CI, $2519.51-$12 370.69; P = .003) and higher mean (SD) population with bachelor’s degrees than counties with pediatric optometrists (79 016 [82 503] vs 23 076 [44 025]; difference, −55 940; 95% CI, −73 035 to −38 845; P < .001), whereas counties with neither specialist type had the lowest mean (SD) household income ($57 714.03 [$2731.00] vs $78 388.67 [$18 499.21]; difference, −$20 675.00; 95% CI, −$21 550.90 to −$19 799.10; P < .001) and mean (SD) population with bachelor’s degrees (5113 [12 875] vs 167 015 [216 486]; difference, −161 902; 95% CI, −170 388.9 to −153 415.1; P < .001) compared with counties with practitioners.Conclusions and RelevanceGeographic disparities in pediatric eye care access, compounded by socioeconomic differences, underscore the urgency of augmenting practitioner support in underserved areas.

中文翻译：

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按从业者类型、地理分布和美国人口统计数据划分的儿科眼科护理获取情况

重要性调查儿科验光师和儿科眼科医生服务覆盖范围与患者人口统计相关的差异，将阐明弱势群体并为未来的干预措施提供信息。目的描述儿科眼保健从业人员的地理分布特征，并分析其与人口统计的关系。设计、设置和参与者在横断面研究中，使用 4 个公共数据库来识别 2023 年 4 月美国儿科验光师和儿科眼科医生的地址。对地址进行地理编码，并收集人口统计数据。本研究纳入了公共数据库中列出的儿科验光师和儿科眼科医生，以及 2020 年美国人口普查的受访者。数据分析时间为 2023 年 4 月至 7 月。暴露公共数据库和美国眼科医师人口普查数据及其执业地点。主要结果和措施公共数据库中列出的儿科验光师和儿科眼科医生的地理分布以及服务覆盖范围与美国人口统计数据之间的相关性。结果A总共确定了 586 名儿科验光师（302 名女性 [51.5%]）和 1060 名儿科眼科医生（590 名男性 [55.7%]）。在美国县中，203 个县 (6.5%) 拥有至少 1 名儿科验光师，308 个县 (9.7%) 拥有至少 1 名儿科眼科医生，显示出明显的地理重叠（比值比，12.7；95% CI，9.4-17.4；磷< .001）。在没有儿科眼科医生的2834个县中，有2731个县（96.4%）缺乏儿科验光师。在所有州，每百万人拥有的儿科眼科医生 (3.3) 比每百万人拥有的儿科验光师 (2.5) 多（差异，0.8；95% CI，0-1.9；磷=.047)。在拥有从业人员的县中，每百万人口拥有儿科验光师的中位数（IQR）为7.8名（0.4-245.0），超过每百万人口拥有儿科眼科医生的中位数（IQR）5.5名（1.0-117.0）。有儿科眼科医生的县的平均家庭收入 (SD) 高于有儿科验光师的县（$76 126.87 [$21 879.23] vs $68 681.77 [$18 336.40]；差异，−$7445.10；95% CI，$2519.51-$12 370.69；磷= .003），拥有学士学位的人口平均数 (SD) 高于拥有儿科验光师的县（79 016 [82 503] vs 23 076 [44 025]；差异，-55 940；95% CI，-73 035 至 -38第845章磷< .001），而没有专业类型的县的家庭平均收入（SD）最低（$57 714.03 [$2731.00] vs $78 388.67 [$18 499.21]；差异，−$20 675.00；95% CI，−$21 550.90 至 −$19 799.10 ;磷< .001）和拥有学士学位的平均（SD）人口（5113 [12 875] vs 167 015 [216 486]；差异，-161 902；95% CI，-170 388.9 至 -153 415.1；磷< .001）与拥有从业人员的县进行比较。结论和相关性儿科眼保健服务的地理差异，再加上社会经济差异，强调了在服务欠缺地区加强从业人员支持的紧迫性。