Distribution gaps in cataract surgery care and impact on seniors across Ontario

Abstract

IntelliHealth database. Cataract surgery claims data were sorted by sex, by age, and by Ontario's 444 municipalities based on patient residence. Cataract surgery distribution was examined by population centre: Large Urban (100 000 persons), Medium (30 000À99 999 persons), Small (1000À29 999 persons), and Rural (<1000 persons) as defined by Statistics Canada. Wait times were extracted from the MOHLTC wait times database. Cataract surgery rate (CSR), defined as the number of cataract surgeries performed per million, was calculated. Results: Cataract surgery volumes remained unchanged from 2010 to 2014. Mean patient age was 71.6 § 10 years. Patients lived in large urban (63%), medium (15%), small (21%), and rural (0.6%) communities. Mean wait times increased by 28% to 68.5 days, and 90th percentile wait times increased by 44% to 154.3 days. A reduction in CSR was observed among seniors aged 65À74 years (¡10%) and 75+ years (¡16%). Rural communities showed the largest decline (¡19%). Among seniors aged 75 years, CSR declined the most for those living in rural communities (¡25%). Conclusions: Adjusting the current government policy of zero-growth in cataract surgery volumes will support growing demands for cataract care in our aging population.Objectif: Évaluer la prestation récente de services en matière de cataractes dans des collectivités de toutes tailles en Ontario. Nature: Analyse rétrospective de dossiers médicaux.Méthodes: À partir de la base de données savoirSANTÉ du ministère de la Santé et des Soins de longue durée (MSSLD) de l'Ontario, on a procédé à l'extraction des données brutes issues des réclamations soumises à l'Assurance-santé de l'Ontario pour des chirurgies de la cataracte (E140A, E214A) entre le 1 er avril 2009 et le 31 mars 2014. Les données sur les réclamations pour des chirurgies de la cataracte ont été triées en fonction du sexe, de l'âge et des 444 municipalités de l'Ontario, d'après le lieu de résidence du patient. La distribution des chirurgies de la cataracte a été répartie selon la classification des centres de population définis par Statistique Canada: grands centres de population urbains (≥ 100 000 habitants), moyens centres de population (30 000 à 99 999 habitants), petits centres (1000 à 29 999 habitants) et régions rurales (< 1000 habitants). Les délais d'attente ont été extraits de la base de données du MSSLD correspondante. On a pu alors calculer le taux de chirurgie de la cataracte (TCC), qui se définissait comme le nombre de chirurgies de la cataracte réalisées par million de personnes. Résultats: Le volume de chirurgies de la cataracte est demeuré le même entre 2010 et 2014. L'âge moyen des patients était de 71,6 ± 10 ans. La répartition des patients en fonction de leur lieu de résidence se détaillait comme suit : grands centres (63 %), moyens centres (15 %), petits centres (21 %) et régions rurales (0,6 %). Le délai d'attente moyen a augmenté de 28 %, pour atteindre 68,5 jours, et le 90 e percentile de délai d'attente a crû de 44 % pour atteindre 154,3 jours. On a enregistré u...

Knowledge about cataract and associated factors among adults in Yirgalem town, Sidama National Regional State, southern Ethiopia, 2020: a community based cross sectional study design

“…Adults 40 years and above were two times more likely to have good knowledge as compared with younger aged group. This is consistent with the study reports from Ontario Canada [ 15 ], surveys in China [ 20 , 21 ]. This might due to the nature of the disease in which the prevalence increases sharply with age and that may lead to support growing demands for cataract care in our aging population.…”

“…The study result showed that, the odds of good knowledge were 81% reduced among study participants from rural residence as compared to the urban resident. This study finding is similar with other studies conducted abroad, central rural India [ 19 ] and Ontario Canada [ 15 ]. This might due to the fact that people living in urban have access to different sources of information regarding the issues in addition to this people living in urban areas have better exposures to media and eye care professionals that increase access to health education and knowledge.…”

“…Participants’ overall score of attitude was assessed using 9 questions that consisted the supportive attitudes towards cataract prevention, Barriers related to patient attitude like (ability to manage routine work, cataract not mature, could see clearly with the other eye, busy with work), and management and finally who scored above the mean score among overall questions was categorized as positive or supportive attitude and negative if the score was less than the mean score [ 15 ].…”

Physician and patient concordance in reporting of appropriateness and prioritization for cataract surgery

“…Age-related cataracts are a the major cause of reversible vision impairment, affecting 95 million people globally and 2.5 million in Canada [ 1 – 3 ]. The impact of vision decline can lead to inability to work, to care for others or to live independently, compromising patient quality of life [ 4 – 6 ].…”

“…Over the past decade, wait times have increased in some countries, including Canada and Portugal, while waits decreased in Spain, and remained stable in New Zealand [ 8 ]. Furthermore, the number of individuals experiencing vision impairment from cataracts is expected to increase with the aging population [ 3 , 9 ]. With respect to patient outcomes, prolonged wait times has been shown to result in patient consequences including vision loss, increased rate of falls and fractures, loss of driver’s license, depression, and overall decreased quality of life [ 4 , 5 ].…”