Geographic distribution of eye-care practitioners in Aotearoa/New Zealand: implications for future eye health workforce

Abstract

Background: The New Zealand Ministry of Health provides funding for the delivery of health care across regions via 20 District Health Boards. Funding includes the subsidisation of therapeutic pharmaceutical agents/drugs. The distribution of optometrists and ophthalmologists across the regions was investigated to understand the accessibility of eye care in New Zealand. Changes made to the optometrists' scope of practice in 2005 and in 2014 increased the range of drugs that suitably qualified optometrists could prescribe. Therefore, the distribution of optometrists authorised to prescribe drugs and those not authorised to prescribe drugs was also investigated. Methods: Information from the New Zealand Optometrists and Dispensing Opticians Board register and information from the Medical Council's website were used to create a database of ophthalmic practitioners and their locations. The χ2 goodness-of-fit test was carried out to determine whether the distribution of the number of practitioners across the regions was in proportion to the population of the regions. Results: Ophthalmologists were distributed across the regions in proportion to the regional population size. However, optometrists were concentrated in Auckland and other regions with high populations. Optometrists authorised to prescribe drugs comprised over 74 per cent of optometrists and were the majority of optometrists in most regions. Many of the regions with populations less than 200,000 had high population-to-practitioner ratios, indicating that they may not have sufficient numbers of ophthalmic practitioners in order to provide for the ocular needs of the community. Conclusion: Better distribution of the optometric workforce could make eye care more accessible in many regions of New Zealand.