[Prioritizing patients on waiting list for cataract surgery: preference differences among citizens]

To estimate and compare citizen preferences regarding patient prioritization for cataract surgery.

A conjoint analysis was performed. Priority criteria were identified and selected using 4 focus/nominal groups consisting of the general public, patients/relatives, allied health-professionals and specialists from Catalonia (n=36). Preferences elicitation (score of criteria): representative sample survey of the above mentioned groups (n=771) and rank-ordered logit model application. Differences were assessed by group analysis and their comparison.

The criteria selected and their relative importance were: visual impairment (45%), difficulty in performing activities of daily living (ADL) (15%), limitation of ability to work (14%), being looked after by someone (11%), being a caregiver (8%), and recovery probability (7%). Differences in scores were observed among groups. Visual impairment was scored more highly by the general public and patients/relatives than by other groups (p<0.001). These two groups also assigned less importance to difficulty in performing ADL (p<0.001). The probability of recovery was the least scored criterion by most groups. Correlations among the order of hypothetical patient scenarios were high (r>0.9). However, the final order of patients on the waiting list could differ by up to 27 positions when different group scores were applied.

Social and clinical criteria were considered important. The observed differences among citizens regarding how to prioritize patients on the waiting lists indicates the need to take into account the preferences of all groups of citizens.