French public care in ophthalmology: a nationwide survey

Abstract

Aim: To describe the medical resources in ophthalmology departments of French public hospitals and to suggest what training needs could be relevant for the future. Methods: An online survey was emailed to heads of ophthalmology departments in French public hospitals, including both general and university hospitals. The questionnaire included data on the ophthalmological emergency services, the demographics and the subspecialties declared by practitioners. Data were statistically analyzed geographically, across administrative areas, in university and non-university hospitals. Results: 145 centers replied to the questionnaire, representing 823 ophthalmologists, of whom 408 were men (49.6%). The mean age of ophthalmologists was 42.4 ± 5.3 years, with 57% of the physicians being under 40 years old and 14% over 60 years old. The medical positions were distributed as follows: hospital practitioners (n = 335; 40.7%), mixed practitioners (n = 179; 21.7%), fellows (n = 156; 18.9%), university fellows (n = 75; 9.1%), professors (n = 63; 7.7%), and associate professors (n = 15; 1.8%). The mean density of public ophthalmologists was 1.37 per 100,000 inhabitants (range: 0-8.4). The distribution of ophthalmologists across the country was characterized by a notable representation of subspecialties such as retina, glaucoma, and cataract surgery. However, the distribution of ophthalmologists specializing in neuro-ophthalmology and ocular inflammation exhibited significant variability. Conclusion: This study highlights significant geographical disparities in the distribution of public ophthalmological care in France, especially in neuro-ophthalmology and ocular inflammation. This preliminary work will facilitate the adjustment of the number of practitioners in public hospitals according to the population's requirement for eye care.