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Retinopathy of prematurity care: Patterns of care and workforce analysis.

Kemper AR, Freedman SF, Wallace DK

Program on Pediatric Health Services Research, Department of Pediatrics, Duke, University, Durham, North Carolina.

PURPOSE: To describe the workforce that provides retinopathy of prematurity (ROP) care. METHODS: We surveyed a random sample of ophthalmologists' offices by telephone (n = 1504) and then sent a mail survey to those who were reported to provide care to infants (n = 486). Workforce estimates were based on the total number of ophthalmologists in the United States. RESULTS: Thirty percent of ophthalmologists were reported to care for children younger than 1 year of age; 11% of all ophthalmologists examine for (1815; 95% confidence interval [95% CI] 1340-2379) and 6% treat ROP (983, 95% CI 649-1421). ROP examinations are provided by an equal number who have completed fellowship training in pediatric ophthalmology and strabismus (254, 95% CI 182-327) as have not completed any fellowship training (236, 95% CI 163-345). Ophthalmologists with fellowship training in any subspecialty provide 86% of the ROP examinations, with those trained in pediatric ophthalmology providing 50% overall. Some (9%) of the ophthalmologists who examine for ROP, regardless of whether or not they completed a fellowship (P = 0.22), report that their training did not adequately prepare them to do so. In contrast to examinations, most treatment is provided by ophthalmologists who are fellowship trained in retina and vitreous diseases. CONCLUSIONS: ROP care is offered by ophthalmologists with different training backgrounds. Future work is needed to understand the relationship between the availability of ophthalmologists and ROP care delivery and the role of new modes of care delivery such as telemedicine.

Published 28 April 2008 in J AAPOS.
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