Access to Pediatric Eye Care Following Vision Screening
Michael Chung; Matthew Fukuda; Benjamin Robinson; Jennifer A. Dunbar; Leila M. Khazaeni
Loma Linda University Eye Institute
Loma Linda, CA
Introduction: Vision screening identifies children who require a comprehensive eye exam. Distance to an eye care provider is a potential barrier to follow up for referred children. This study quantifies geographic distances and driving times between screening centers and follow-up locations and correlates these with median household income.
Methods: Driving times between vision screening centers and local eye care providers (pediatric ophthalmologists and optometrists agreeing to participate) were mapped and analyzed using OpenStreetMap software (Esri, Redlands,CA). Population density and median household income was linked with screening centers using ArcGIS online (Esri, Redlands,CA).
Results: 290 driving times for routes between 145 screening centers, 7 pediatric ophthalmologists, and 147 optometrists comprising a community vision screening program were calculated and mapped. Median driving times from a screening center to the nearest eye care provider were 25.10 minutes (ophthalmologist) and 4.74 minutes (optometrist). 90% of screening centers were located within one hour of an eye care provider. Decreased driving times correlated with increased population and median household income.
Discussion: Comprehensive exam following vision screening is important to the success of a community vision screening program. Although median driving times remained relatively low in this study, children in outlying communities still faced geographic barriers to follow up care with a pediatric ophthalmologist. These areas correlated with lower median family income.
Conclusion: Geolocation allows a screening program to recruit appropriate providers for comprehensive care in close proximity to the locations they screen and to plan screenings so as to reduce geographic and economic barriers to care.
References: 1. Lee CS, Morris A, Gelder RNV, Lee AY. Evaluating access to eye care in the contiguous united states by calculated driving time in the united states medicare population. Ophthalmol 2016; 123:2456-2461.
2. Williams, Summer et al. The challenges to ophthalmologic follow-up care in at-risk pediatric populations. J AAPOS 2013; 17:140-143