June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Characterization of Ophthalmology Market Saturation and Patient Access
Author Affiliations & Notes
  • Sean Berkowitz
    VEI, Vanderbilt University School of Medicine, Nashville, Tennessee, United States
  • Yuhan Liu
    Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States
  • Qingxia Chen
    Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States
  • Shriji Patel
    Department of Ophthalmology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Footnotes
    Commercial Relationships   Sean Berkowitz, None; Yuhan Liu, None; Qingxia Chen, None; Shriji Patel, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2655. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Sean Berkowitz, Yuhan Liu, Qingxia Chen, Shriji Patel; Characterization of Ophthalmology Market Saturation and Patient Access. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2655.

      Download citation file:

      © ARVO (1962-2015); The Authors (2016-present)

  • Supplements

Purpose : The national underutilization of eyecare services warrants study of the correlation between geographic market saturation and realized access

Methods : Observational cohort study using datasets from Centers for Medicare & Medicaid Services, U.S. Census Bureau, U.S. Department of Agriculture, and Housing and Urban Development, to calculate county- and state-level ophthalmologic service usage, market saturation, and demographic characteristics. Negative binomial regression models were used to evaluate the association between results and demographic or population-specific variables.

Results : Ophthalmologic service usage ranged from 58.200% to 15.170%, while saturation ranged from 21763.00 to 91.40 FFS beneficiaries per registered ophthalmologist. Uage was stastically significantly associated with several demographic characteristics in each geography: lower proportion of African American (b= -0.091, 95% CI: (-0.159, -0.022), p= 0.009), Hispanic (b= -0.226, 95% CI: (-0.318, -0.133), p < .001), and other race beneficiaries (b = -0.408, 95% CI: (-0.520, -0.294), p < .001), relative to the proportion of white beneficiaries; a higher proportion of female (b = 2.709, 95% CI (2.347,3.072)), p<.001) relative to male; a higher proportion of adults having completed an associate degree or some college (b= 0.255, 95% CI: (0.098, 0.412)), p = 0.001), or holding a bachelor’s degree or higher (b= 0.405, 95% CI: (0.301, 0.508)), p < .001), relative to the proportion of adults with only a highschool diploma; a lower proportion of adults in each geography experiencing poverty (b= -0.236, 95% CI: (-0.413, -0.060), p = .009), geographies with lower Multidimensional Deprivation Index (b= -0.234, 95% CI: (-0.358, -0.109), p < .001); a higher urban-influence code ( b= 0.008, 95% CI: (0.006, 0.010), p < .001).

There was no significant correlation between the usage of ophthalmologic services and the geographic market saturation of ophthalmologists (Spearman’s rho -0.030, p= 0.227).

Conclusions : Ophthalmologic service usage is significantly influenced by population demographics and contextual factors. The presence of more ophthalmologists may benefit local population health; however, increased provider density alone appears insufficient to promote the usage of eye care services. As ophthalmologists try to meet the needs of their local population, focus on individual and contextual barriers may help increase realized access and improve population health.

This is a 2021 ARVO Annual Meeting abstract.




This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.