Exploring the growth patterns of medical demand for eye care: a longitudinal hospital-level study over 10 years in China

BACKGROUND: The increasing demand for eye care inflicts a heavy burden on the eye care system. The uneven distribution of demand dynamically exacerbates the supply-demand imbalance. Systematic explorations of the growth patterns of the demand for eye care are needed to detect potential influences on the safety and quality of medical services. METHODS: This is an observational longitudinal study at the hospital level. We exported 8 million outpatient visit records over 10 years from the electronic health record (EHR) system of Zhongshan Ophthalmic Center (ZOC). The total visits to all levels of medical institutions in China were collected from the websites of the China National Statistics Bureau. The target 10-year period was from Jan 1, 2008, to Dec 31, 2017. Revisit intervals were analysed to assess the stickiness of patient demand. The proportions of non-local patients (from cities other than Guangzhou in Guangdong Province, or provinces other than Guangdong Province in China) were analysed to assess flowing demand liquidity. RESULTS: Visits to medical institutions continuously increased over the examined period (2008–2017) in China. Increasing patient visits and corresponding supplementation of doctors broke the supply-demand balance at ZOC. In terms of the temporal aspect, uneven distributions over cycles of weeks and years, referred to as Monday peaks and vacation peaks, became more evident during the examined period. With respect to geography, the coverage of demand sources expanded to the whole nation, and the flowing demand accounted for higher proportions at both the city and province levels. Subdepartments of ophthalmology had diverse growth speeds and proportions of flowing demand. Patients presented higher stickiness with shorter revisit intervals, and non-locals had higher stickiness than local patients. CONCLUSIONS: The growth patterns of demand for eye care indicate potential challenges for ophthalmologists at the hospital level, including regular workload peaks, a wider range of patients with diverse cultural backgrounds, and higher stickiness of patients.