A retrospective population-based analysis of wait times for cataract surgery in Ontario, Canada
Marko M Popovic1, Mack Hurst1, Lori M Diemert1
1Department of Ophthalmology and Vision Sciences (Popovic, El-Defrawy, Ahmed, Schlenker), and Dalla Lana School of Public Health (Hurst, Diemert, Rosella), University of Toronto; ICES UofT (Hurst, Rosella), Toronto, Ont.; Institute for Better Health (Chu, Yang, Ahmed, Rosella, Schlenker), Trillium Health Partners, Mississauga, Ont.; Kensington Eye Institute (El-Defrawy, Schlenker), Toronto, Ont.
Background:
Current methods used to estimate surgical wait times in Ontario may be subject to inconsistencies and inaccuracies. In this population-level study, we aimed to estimate cataract surgery wait times in Ontario using a novel, objective and data-driven method.
Methods:
We identified adults who underwent cataract surgery between 2005 and 2019 in Ontario, using administrative records. Wait time 1 represented the number of days from referral to initial visit with the surgeon, and wait time 2 represented the number of days from the decision for surgery until the first eye surgery date. In the primary analysis, a ranking method prioritized referrals from optometrists, followed by ophthalmologists and family physicians.
Results:
The cohort consisted of 1 138 532 people with mostly female patients (57.4%) and those aged 65 years and older (79.0%). In the primary analysis, the median was 67 days for wait time 1 (interquartile range [IQR] 29-147). There was a median of 77 days for wait time 2 (IQR 37-155). Overall, the following proportions of patients waited less than 3, 6 and 12 months: 54.1%, 78.5% and 91.7%, respectively. For wait time 2, the proportions of patients who waited less than 3, 6 and 12 months were 49.5%, 77.1% and 93.3%, respectively. In total, 19.3% of patients did not meet the provincial target for wait time 1, 20.5% did not meet the target for wait time 2 and 35.0% did not meet the target for wait times 1 or 2.
Interpretation:
Administrative health services data can be used to estimate cataract surgery wait times. With this method, 35.0% of patients in 2005-2019 did not receive initial consultation or surgery within the provincial wait time target.
