Authors: Shicheng (Tony) Jin, Sherif El-Defrawy, Jonathan A. Micieli, Ya-Ping Jin, Peng Yan
Author Disclosure Block: S. Jin: None. S. El-Defrawy: None. J.A. Micieli: None. Y. Jin: None. P. Yan: None.

Abstract Body:

Purpose: To assess trends in ophthalmology and optometry providers across Ontario, Canada.
Study Design: Retrospective population-based analysis.
Methods: Ontario Health Insurance Plan (OHIP) medical provider data from April 1^st 2010 to March 31^st 2016 was extracted from the Ministry of Health and Long Term Care IntelliHealth database. Ophthalmology and optometry provider data was analyzed by sex, age, municipality, Local Health Integration Network and population centre: large urban (≥100,000 persons), medium (30,000-99,999 persons), small (1,000-29,999 persons), and rural (<1,000 persons) as defined by Statistics Canada.
Results: From 2011 to 2016, Ontario’s population increased by 5.4% while the number of optometrists increased significantly more than the number of ophthalmologists per 100,000 people (+14.6% vs +1.6%; p<0.05).
Over the 5-year period, on average ophthalmologists were 53±13 years old and 20±1% female. During this time, the ratio by sex stayed consistent at 1F:4M with no significant shifts among age groups: ≤34 (8%), 35-49 (33%), 50-64 (38%), 65+ (21%). By geography, ophthalmologists practiced in 61/444 (13.7%) municipalities where 77.9% of Ontarians live. Over the 5-year period, the change in ophthalmologists per 100,000 vs population was -20.1% vs +2.4% for small centres, +10.6% vs +2.0% for medium centres and -0.6% vs +8.5% for large urban centres. No ophthalmologists practiced in rural communities.
Over the 5-year period, on average optometrists were 43±12 years old and 51±2% female. During this time, the ratio by sex stayed consistent at 1F:1M with no significant shifts among age groups: ≤34 (30%), 35-49 (39%), 50-64 (27%), 65+ (21%). By geography, optometrists practiced in 160/444 (36.0%) municipalities where 92.2% of Ontarians live. From 2011 to 2016, the change in optometrists per 100,000 vs population was -2.7% vs +2.8% for small centres, +10.2% vs +4.0% for medium centres and +15.5% vs +8.5% for large urban centres. No optometrists practiced in rural communities.
Conclusions: From 2011 to 2016, per 100,000 population the number of optometrists has increased significantly more than the number of ophthalmologists. Compared to ophthalmology, the optometry workforce is younger and practices in significantly more communities across Ontario. In urban areas, there has been a large increase in optometrists while the corresponding number of ophthalmologists has decreased. In smaller communities, the number of both optometrists and ophthalmologists has decreased, with ophthalmology experiencing the largest decrease. Careful human resource planning is needed to prevent oversupply of optometrists and undersupply of ophthalmologists.