加拿大安大略省白内障手术等待时间的回顾性人群分析。

CMAJ open Pub Date : 2023-03-01 DOI:10.9778/cmajo.20220035
Marko M Popovic, Mack Hurst, Lori M Diemert, Casey Chu, Mike Yang, Sherif El-Defrawy, Iqbal Ike K Ahmed, Laura Rosella, Matthew B Schlenker
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引用次数: 0

摘要

背景:目前用于估计安大略省手术等待时间的方法可能存在不一致性和不准确性。在这项人口水平的研究中,我们旨在使用一种新颖、客观和数据驱动的方法来估计安大略省白内障手术的等待时间。方法:我们使用行政记录确定了安大略省2005年至2019年间接受白内障手术的成年人。等待时间1表示从转诊到外科医生首次就诊的天数,等待时间2表示从决定手术到第一次眼科手术日期的天数。在初步分析中,排序法优先考虑验光师的转诊,其次是眼科医生和家庭医生。结果:该队列共纳入1 138 532例患者,其中女性患者占57.4%,65岁及以上患者占79.0%。在初步分析中,等待时间1的中位数为67天(四分位数间距[IQR] 29-147)。等待时间2的中位数为77天(IQR 37-155)。总的来说,等待时间少于3个月、6个月和12个月的患者比例分别为54.1%、78.5%和91.7%。等待时间2小于3个月、6个月和12个月的患者比例分别为49.5%、77.1%和93.3%。总共有19.3%的患者没有达到省级目标的等待时间1,20.5%的患者没有达到省级目标的等待时间2,35.0%的患者没有达到省级目标的等待时间1或2。解释:行政卫生服务数据可用于估计白内障手术等待时间。采用该方法,2005-2019年35.0%的患者未在省级等待时间目标内获得初次会诊或手术。
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A retrospective population-based analysis of wait times for cataract surgery in Ontario, Canada.

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.

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