Characteristics of Uveitis Specialists and Disparities in Geographic Access to Uveitis Care in the United States

Abstract

Purpose: To characterize uveitis specialists and identify the sociodemographic and geographic access disparities to uveitis care in the United States. Methods: In this retrospective, cross-sectional study, we identified uveitis specialists using 3 public online databases. Descriptive statistics were used to characterize uveitis specialists. An origin-destination cost matrix was used to assess travel time and distance from each US census tract to the nearest uveitis specialist. Results: We identified 447 uveitis specialists in the United States. Of these, 122 (27.3%) were women. Most (280 [62.6%]) had medical and/or surgical retina training. More than half (265 [59.3%]) completed a uveitis-specific fellowship. The majority (257 [57.5%]) were in private practice. Greater proportions of university or hospital-based (51.7% vs 29.1%; P < .001) and female (79.5% vs 51.7%; P < .001) uveitis specialists completed uveitis-specific fellowship training. More female uveitis specialists practiced in university or hospital-based settings (54.9% vs 37.8%; P < .001). No uveitis specialists were identified in 6 states. Mean ± SD travel time and distance to the nearest uveitis specialist were 45.8 ± 51.9 minutes and 40.7 ± 55.9 miles (65.5 ± 89.9 km), respectively. In a multivariate regression analysis, those traveling 60 miles (96.6 km) or more to the nearest uveitis specialist were more likely to reside in rural census tracts that were rural (P < .001), outside the Northeast (P < .001), and with greater proportions of the population below the federal poverty level (P < .001). Conclusions: There are imbalances in the composition of identified uveitis specialists and in the geographic access to uveitis care in the United States. These imbalances help to inform the allocation of training resources and to emphasize areas of critical need for uveitis care.