Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-24T05:52:13.600Z Has data issue: false hasContentIssue false
  • English
  • Français

Non-Clinical Factors Associated with Variation in Cataract Surgery Waiting Times in Manitoba

Published online by Cambridge University Press:  31 March 2010

Carolyn De Coster
Carolyn De Coster*
Affiliation:
Department of Community Health Sciences, University of Manitoba
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Carolyn De Coster, Ph.D., R.N., Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, 727 McDermot Avenue, Suite 408, Winnipeg, MB R3E 3P5. ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Cataract surgery is the highest-volume surgical procedure in Canada, with over 200,000 performed annually, mostly (85%) on persons aged 65 or older. Concerns have been raised about wait times to access this procedure. This study explores the relationship between waiting times for cataract surgery in Manitoba and a variety of characteristics, including age, sex, socio-economic status, region of residence, health status, surgeon, and surgeon's caseload. The study included 6,114 individuals who had first-eye cataract surgery between November 1, 1998, and March 31, 2000, in Winnipeg, MB. Significant predictors of variation in wait times were age, sex, having a hospitalization while waiting, and surgeon. The model explained 32.5 per cent of the variance in wait times; specific surgeon independently explained 29.5 per cent of the variance. Median waiting times varied widely by surgeon, ranging from 61 to 399 days. Differences in surgeons' expected wait times should be available to patients and referring clinicians.

Résumé

L'opération de la cataracte constitue l'intervention chirurgicale la plus répandue au Canada, plus de 200 000 opération de ce genre étant effectuées chaque année, la plupart du temps (85 p. 100) sur des gens de 65 ans ou plus. Des inquiétudes ont été soulevées au sujet des délais d'attente pour subir cette procédure. Cette étude traite des liens entre les délais d'attente pour les opérations de la cataracte au Manitoba et diverses caractéristiques, notamment l'âge, le sexe, la situation socioéconomique, la région de résidence, l'état de santé, le chirurgien ainsi que le nombre de cas que le chirurgien doit traiter. L'étude portait sur 6 114 sujets ayant subi une première opération de la cataracte entre le 1er novembre 1998 et le 31 mars 2000, à Winnipeg, au Manitoba. Parmi les facteurs permettant de prédire la variation des délais d'attente, on compte l'âge, le sexe, le chirurgien et le fait d'être hospitalisé pendant l'attente. Le modèle élaboré permettait d'expliquer la variation des délais d'attente dans 32,5 p. 100 des cas ; le choix du chirurgien permettait d'expliquer à lui seul 29,5 p. 100 de la variation. Le délai d'attente moyen variait beaucoup selon les chirurgiens, allant de 61 à 399 jours. Les patients et les médecins traitants devraient avoir accès aux données concernant les différents délais d'attente prévus selon les chirurgiens.

Keywords

agedagingcataract extractionmultivariate analysisregistriesretrospective studieswaiting listspersonnes âgéesvieillissementexcision de la cataracteManitobaanalyse multifactorielleregistresétudes rétrospectiveslistes d'attente
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 24 , Issue S1: Health and Health Care Use Among Older Adults: Using Population-Based Information Systems to Inform Policy in Manitoba , Spring/Printemps 2005 , pp. 47 - 58
Copyright
Copyright © Canadian Association on Gerontology 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aiono, S., Faber, R.G., & Galland, R.B. (2000). Surgeons have little control over general surgical waiting lists. Annals of the Royal College of Surgeons of England, 82, 304–307.Google ScholarPubMed
Alberta Medical Association. (1999). Information for patients: Cataracts in adults with otherwise health eyes. Edmonton: Author.Google Scholar
Alonso, J., Espallargues, M., Andersen, T.F., Cassard, S.D., Dunn, E., Bernth-Petersen, P., Norregaard, J.C., Black, C., Steinberg, E.P., & Anderson, G. (1997). International applicability of the VF-14: An index of visual function in patients with cataracts. Ophthalmology, 104, 799–807.CrossRefGoogle ScholarPubMed
Alter, D.A., Naylor, C.D., Austin, P., & Tu, J.V. (1999). Effects of socioeconomic status on access to invasive cardiac procedures and on mortality after acute myocardial infarction. New England Journal of Medicine, 341(18), 1359–1367.CrossRefGoogle ScholarPubMed
American Academy of Ophthalmology. Age-related cataract? [Online]. 2003. Available from http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZJOJW8OPC&sub_cat=1119Google Scholar
Armstrong, W. (2000). The consumer experience with cataract surgery and private clinics in Alberta: Canada's canary in the mine shaft. Edmonton: Alberta Chapter of the Consumers Association of Canada.Google Scholar
Bellan, L., & Mathen, M. (2001). The Manitoba cataract waiting list program. Canadian Medical Association Journal, 164(8), 1177–1180.Google ScholarPubMed
Cassard, S.D., Patrick, D.L., Damiano, A.M., Legro, M., Tielsch, J.M., Diener-West, M., Schein, O.D., Javitt, J.C., Bass, E.B., & Steinberg, E.P. (1995). Reproducibility and responsiveness of the VF-14: An index of functional impairment in patients with cataracts. Archives of Ophthalmology, 113(12), 1508–1513.CrossRefGoogle ScholarPubMed
Castells, X., Alonso, J., Ribo, C., Nara, D., Teixido, A., & Castilla, M. (2000). Factors associated with second eye cataract surgery. British Journal of Ophthalmology, 84(1), 9–12.CrossRefGoogle ScholarPubMed
Churchill, A.J., Vize, C.J., Stewart, O.G., & Backhouse, O. (2000). What factors influence cataract waiting list time? British Journal of Ophthalmology, 84(4), 429–431.CrossRefGoogle ScholarPubMed
De Coster, C. (2002). Measurement and factors relating to variation in cataract surgery waiting times in Manitoba. Unpublished doctoral dissertation, University of Manitoba.Google Scholar
De Coster, C., Carrière, K.C., Peterson, S., Walld, R., & MacWilliam, L. (1998). Surgical waiting times in Manitoba. Winnipeg: Manitoba Centre for Health Policy and Evaluation.Google Scholar
De Coster, C., Carrière, K.C., Peterson, S., Walld, R., & MacWilliam, L. (1999). Waiting times for surgical procedures. Medical Care, 37(Suppl. 6), JS187–JS205.Google ScholarPubMed
De Coster, C., MacWilliam, L., & Walld, R. (2000). Waiting times for surgery: 1997/98 and 1998/99 update. Winnipeg: Manitoba Centre for Health Policy and Evaluation.Google Scholar
Desai, P. (1993). National cataract surgery survey: II Clinical outcomes. Eye, 7, 489–494.CrossRefGoogle ScholarPubMed
Dunn, E., Black, C., Alonso, J., Norregaard, J.C., & Anderson, G.F. (1997). Patients' acceptance of waiting for cataract surgery: What makes a wait too long? Social Science and Medicine, 44, 1603–1610.CrossRefGoogle ScholarPubMed
First Ministers. (2000). First ministers' meeting: Communiqué on health. September 11, 2000.Google Scholar
Frohlich, N., Fransoo, R., & Roos, N.P. (2001). Indicators of health status and health service use for the Winnipeg Regional Health Authority. Winnipeg: Manitoba Centre for Health Policy and Evaluation.Google Scholar
Goddard, J.A., & Tavakoli, M. (1998). Referral rates and waiting lists: Some empirical evidence. Health Economics, 7(6), 545–549.3.0.CO;2-R>CrossRefGoogle ScholarPubMed
Hadjistavropoulos, H.D., Snider, B., & Bartlett, G. (1998). Measuring the quality of performance in the management of waiting lists: Using cataract surgery as an example. Joint Commission Journal on Quality Improvement, 24(8), 407–422.Google ScholarPubMed
Hadorn, D.C., & Steering Committee of the Western Canada Waiting List Project. (2000). Setting priorities for waiting lists: Defining our terms. Canadian Medical Association Journal, 163, 857–860.Google ScholarPubMed
Hamblin, R., Harrison, A., & Boyle, S. (1998). Waiting lists: The wrong target. Health Services Journal, 108(5598), 28–31.Google ScholarPubMed
Harley, M. (2001). Waiting lists: Bone of contention. Health Services Journal, 111(5755), 22–25.Google ScholarPubMed
Imamura, K., Gair, R., McKee, M., & Black, C. (1996). Appropriateness of total hip replacement in the United Kingdom. World Hospitals and Health Services, 32(2), 10–14.Google ScholarPubMed
Kee, F., & Gaffney, B. (1995). Priority for coronary artery surgery: Who gets by-passed when demand outstrips capacity. Quarterly Journal of Medicine, 88, 15–22.Google ScholarPubMed
Kee, F., McDonald, P., & Gaffney, B. (1997). Prioritising the cardiac surgery waiting list: The angina patient's perspective. Heart, 77(4), 330–332.CrossRefGoogle ScholarPubMed
Leinonen, J., & Laatikainen, L. (1999). The decrease of visual acuity in cataract patients waiting for surgery. Acta Ophthalmologica Scandinavica, 77(6), 681–684.CrossRefGoogle ScholarPubMed
Lundstrom, M., Fregell, G., & Sjoblom, A. (1994). Vision related daily life problems in patients waiting for a cataract extraction. British Journal of Ophthalmology, 78(8), 608–611.CrossRefGoogle ScholarPubMed
Mariotto, A., De Leo, D., Buono, M.D., Favaretti, C., Austin, P., & Naylor, C.D. (1999). Will elderly patients stand aside for younger patients in the queue for cardiac services? Lancet, 354(9177), 467–470.CrossRefGoogle ScholarPubMed
Martin, M. (1995). Quebec hopes to overcome province's surgical-delay problem. Canadian Medical Association Journal, 153(7), 1001–1002.Google ScholarPubMed
Minassian, D.C., Reidy, A., Desai, P., Farrow, S., Vafidis, G., & Minassian, A. (2000). The deficit in cataract surgery in England and Wales and the escalating problem of visual impairment: Epidemiological modelling of the population dynamics of cataract. British Journal of Ophthalmology, 84(1), 4–8.CrossRefGoogle ScholarPubMed
Naylor, C.D., Morgan, C.D., Levinton, C.M., Wheeler, S., Hunter, L., Klymciw, K., Baigrie, R.S., & Goldman, B.S. (1993). Waiting for coronary revascularization in Toronto: 2 years' experience with a regional referral office. Canadian Medical Association Journal, 149(7), 955–962.Google ScholarPubMed
Norregaard, J.C., Hindsberger, C., Alonso, J., Bellan, L., Bernth-Petersen, P., Black, C., Dunn, E., Andersen, T.F., Espallargues, M., & Anderson, G.F. (1998). Visual outcomes of cataract surgery in the United States, Canada, Denmark, and Spain: Report from the International Cataract Surgery Outcomes Study. Archives of Ophthalmology, 116(8), 1095–1100.CrossRefGoogle ScholarPubMed
Noseworthy, T.W., McGurran, J.J., Hadorn, D.C., & Steering Committee of the Western Canada Waiting List Project. (2003). Waiting for scheduled service in Canada: Development of priority-setting scoring systems. Journal of Evaluation in Clinical Practice, 9, 23–31.CrossRefGoogle ScholarPubMed
Pell, J.P., Pell, A.C., Norrie, J., Ford, I., & Cobbe, S.M. (2000). Effect of socioeconomic deprivation on waiting time for cardiac surgery: Retrospective cohort study. British Medical Journal, 320, 15–19.CrossRefGoogle ScholarPubMed
Pope, C., & Roberts, J.A. (1991). Dissecting a waiting list. Health Service Management Research, 4(2), 112–119.CrossRefGoogle ScholarPubMed
Reid, R., MacWilliam, L., Roos, N.P., Bogdanovic, B., & Black, C. (1999). Measuring morbidity in populations: Performance of the Johns Hopkins Adjusted Clinical Group (ACG) Case-Mix Adjustment System. Winnipeg: Manitoba Centre for Health Policy and Evaluation.Google Scholar
Romanchuk, K., Sanmugasunderam, S., Hadorn, D.C., & Steering Committee of the Western Canada Waiting List Project. (2002). Developing cataract surgery priority criteria: Results from the Western Canada Waiting List Project. Canadian Journal of Ophthalmology, 37, 145–154.CrossRefGoogle ScholarPubMed
Roos, L.L., Sharp, S.M., & Cohen, M.M. (1991). Comparing clinical information with claims data: Some similarities and differences. Journal of Clinical Epidemiology, 44(9), 881–888.CrossRefGoogle ScholarPubMed
Roos, L.L., Mustard, C.A., Nicol, J.P., McLerran, D.F., Malenka, D.K., Young, K.T., & Cohen, M.M. (1993). Registries and administrative data: Organization and accuracy. Medical Care, 31(3), 201–212.CrossRefGoogle ScholarPubMed
Sanderson, H.F. (1982). What's in a waiting list. British Medical Journal, 285, 1368–1369.CrossRefGoogle Scholar
Singh, N., Gupta, M., Fell, D., & Gangbar, E. (1999). Impact and inequity of inpatient waiting times for advanced cardiovascular services in community hospitals across the greater Toronto area. Canadian Journal of Cardiology, 15(7), 777–782.Google ScholarPubMed
Sobolev, B., Brown, P., & Zelt, D. (2001). Potential for bias in waiting time studies: Events between enrolment and admission. Journal of Epidemiology and Community Health, 55, 891–894.CrossRefGoogle ScholarPubMed
Western Canada Waiting List Project. (2001). From chaos to order: Making sense of waiting lists in Canada: Final Report. Edmonton: Author.Google Scholar
Williams, J.I., & Young, W. (1997). Inventory of studies on the accuracy of Canadian health administrative databases. Toronto: Institute for Clinical Evaluative Sciences.Google Scholar
Wong, T.Y. (2001). Regular review: Effect of increasing age on cataract surgery outcomes in very elderly patients. British Medical Journal, 322(7294), 1104–1106.CrossRefGoogle Scholar
Wright, C.J., & Robens-Paradise, Y. (2001). Evaluation of indications and outcomes in elective surgery. Vancouver: Vancouver/Richmond Health Board.Google Scholar
Wright, C.J., & Robens-Paradise, Y. (2002). Evaluation of indications for and outcomes of elective surgery. Canadian Medical Association Journal, 167(5), 461–466.Google ScholarPubMed