Original article
An investigation of the relationship between cataract surgery wait times and rates of surgery

https://doi.org/10.1016/j.jcjo.2011.12.023Get rights and content

Abstract

Objective

The relationship between cataract surgery wait times and rates of surgery was investigated to determine whether wait times correlate with rates of surgery.

Design

Cross-sectional study.

Participants

We collected 2 Ontario registries for cataract surgeries: (i) Cancer Care Ontario wait time registry; and (ii) The Ontario Health Insurance Plan billing records.

Methods

Both registries were used to determine whether wait times correlated with rates of surgery, and the data were then stratified by region of the province, priority (severity) of cases, age, and sex.

Results

The total number of surgeries performed between April 2, 2007, and March 31, 2008, was 65,520. The overall mean number of wait days was 69.8 days; the mean patient age was 72.5 years; and the surgery rate was 540.3 per 100,000 members of the population. For high-priority cases (priorities 1 and 2), there was a very weak inverse correlation (p = −0.27 and −0.21) between wait time and surgery rate, whereas the overall correlation between wait time and surgical rate was close to zero in both databases, regardless of the region, the patients' ages, and the patients' genders.

Conclusions

This study demonstrates a very weak correlation between wait times for and rates of cataract surgery, and this should be a concern for policy makers. Further study is needed to see whether this null relationship persists over time and whether it exists for other monitored wait time procedures. Reasons for this null relationship will have to be determined and remedied as the use of wait times becomes a more widespread outcome in Canadian Healthcare.

Résumé

Objet

Investigation de la relation entre le temps d'attente d'une chirurgie de la cataracte et les taux de chirurgie pour déterminer s'il y a une corrélation entre ces deux éléments.

Nature

Étude transversale.

Participants

Deux registres ontariens de chirurgie de la cataracte ont été recueillis : 1) Registre des temps d'attente aux Soins de cancer d'Ontario; 2) Dossiers de facturation du Régime d'assurance santé d'Ontario.

Méthodes

Les deux registres ont servi à déterminer si le temps d'attente était corrélé au taux de chirurgie. Les données furent alors réparties selon les régions de la province, la priorité (sévérité) des cas, l'âge et le genre.

Résultats

Le nombre total de cas effectués entre le 2 avril 2007 et le 31 mars 2008 s'élevait à 65 520. La moyenne globale de jours d'attente s'élevait à 68,8 jours, l'âge moyen des patients était 72,5 ans et le taux de chirurgie était de 540,3 par 100 000 de population. Pour les cas de priorité élevée (Priorités 1 et 2), la corrélation inverse était très faible (p= -0,27 et -0,21) entre le taux de chirurgie et le temps d'attente alors que la corrélation globale, temps d'attente et taux de chirurgie, s'approchait de zéro en regard des deux bases de données indifféremment de la région, de l'âge et du genre des patients.

Conclusions

Cette étude démontre une très faible corrélation entre le temps d'attente pour la cataracte et les taux de chirurgie, ce qui pourrait être une préoccupation pour les décideurs politiques. D'autres études s'avèrent nécessaires pour voir si cette relation insignifiante persistera avec le temps et si elle existera pour d'autres monitorages de temps d'attente des procédures. Les raisons pour cette relation nulle devront être établies et il faudra y remédier, à mesure que l'utilisation des temps d'attente à titre de mesure des résultats devient de plus en plus répandu dans le régime des soins de santé au Canada.

Section snippets

Methods

We studied whether, and how, rates of cataract surgery are correlated with and predict wait times. To accomplish this, we calculated the rate of cataract surgery in each Localized Health Integration Network (LHIN) in Ontario and determined wait times per LHIN, both prospectively, through wait-time information gained from the Cancer Care Ontario (CCO).

Wait Times Information Office database, and retrospectively, using Ontario Health Insurance Plan (OHIP) billing records. We also did this

Results

The overall provincial wait-time data are summarized in Table 1. The overall mean number of wait days for the 65,520 procedures was 69.8 days; the mean patient age was 72.5 years; and the surgery rate in the province was 540.3 per 100,000 patients. This crude rate is very similar to the rates published in other industrialized countries (548/100,000),9 and age and sex standardized rates using this U.S. external standard is 545 per 100,000. Of the cases, 65% were patients older than 70 years, and

Discussion

Based on the multivariate analysis and correlations, the overall wait-to-rate correlation is poor. The correlation between overall wait times and surgical rates is close to zero in both databases. For high-priority cases (Priorities 1 and 2) that can be stratified, there is a weak to moderate inverse correlation, as one would expect; concluding wait times are reduced as surgical rates increases. However, even in these high-priority cases, the relationship is weak (p = −0.27 and −0.21). In

Disclosure

The authors have no proprietary or commercial interest in any materials discussed in this article.

Acknowledgements

We give thanks to Health Canada and Canadian Institutes of Health Research for the funding support. We thank Ontario Ministry of Health and Long-Term Care (MHLTC) and Cancer Care Ontario for providing the databases. We also thank Jim Jaffey for helping with the data analysis.

References (18)

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Cited by (4)

  • Wait times and volume of cataract surgery in Ontario: 2000—2012

    2016, Canadian Journal of Ophthalmology
    Citation Excerpt :

    One must be cautious when interpreting wait times and relating them to surgical rates. Previous studies in Ontario found little to no correlation between wait times and rates of cataract surgery.5,14 A weak inverse correlation was noted for high-priority cases, but close to zero correlation existed overall.

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    2018, Ophthalmic Plastic and Reconstructive Surgery

Supported by Health Canada, Health Care Policy Contribution Program, Agreement # 6804-15-2008/9000010-CIHR, Synthesis Grant- FRN# 83308

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