Waiting times for eye surgery at a Toronto teaching hospital

Abstract

Background: Waiting times for eye surgery in Ontario have increased dramatically in recent years. We performed a study to compare the waiting times, the amount of operating time and the number of cases performed for various eye surgical procedures in 1999, 2000 and 2001 at a major Toronto teaching hospital.

Methods: For 3 months (May, June and July) of 1999, 2000 and 2001, eye surgeons at the hospital reported how long their patients had to wait for surgery and how many patients they had waiting for surgery. The number of operating hours for eye surgery and the number of eye surgery cases in fiscal years 1999-2000, 2000-01 and 2001-02 were collected from a hospital database. Surgical procedures that were captured were cataract extraction, corneal transplantation, trabeculectomy (including phacotrabeculectomy), vitreoretinal surgery and adult strabismus surgery.

Results: All surgeons responded to the survey. Median waiting times increased for all types of eye surgery between 1999 and 2001. The median wait for cataract extraction increased by 92%, from 3.0 to 5.8 months. For corneal transplantation the median wait doubled, from 5.5 to 11.0 months. The median wait for trabeculectomy increased by 60%, from 2.5 to 4.0 months. The median wait for vitreoretinal surgery almost tripled (191%), from 1.2 to 3.4 months. For adult strabismus surgery the median wait increased by 56%, from 8.0 to 12.5 months. Operating time was cut by over 1000 hours (from 5481 to 4434) from 1999-2000 to 2000-01 and then again, by 255 hours, from 2000-01 to 2001-02. Despite this, the number of surgical procedures performed decreased only slightly over the study period, from 4292 to 4099.

Interpretation: The waiting times for all eye operations increased substantially between 1999 and 2001 at this Toronto teaching hospital. In addition, for each type of surgery the median waiting time was longer than the Ontario median, by 13% (cataract surgery) to 191% (vitreoretinal surgery). The fact that the number of cases performed decreased only slightly despite a dramatic decrease in operating time indicates that there was an increase in efficiency. Possible ways to reduce the long waits include implementing prioritization programs, increasing operating time and moving cataract surgery out of the hospital to a day surgical centre.