Hidden Wait Times & Associated Costs for Cataract Surgery: A Potential Solution
Title of Article: The true cost of hidden waiting times for cataract surgery in Australia
What are the key takeaway points from this article?
Cataract surgery is a very safe and effective procedure to address preventable blindness, however access is inequitable. Wait times are often presented as time from first being seen by an ophthalmologist to surgery, however there is often a significant wait time before seeing an ophthalmologist. In the majority of cases, this wait time is over 8 months, making the total wait between 4 and 30 months. Patient health outcomes during this time are negative, and cost the healthcare system more in the long run according to recent literature. While visual impairment leads to a decreased quality of life, it can also lead to increased falls, and motor vehicle accidents (MVAs). This report suggests that incidence rate of falls before surgery is 1.17, between is 0.88, and after was 0.58, which was significant.
When analyzing the number of falls, the additional cost to the healthcare system with a 12 month wait compared to 3 months was $20.3 million. The costs associated with seeing these patient consults sooner, and having their surgeries within a 3 month period were an additional $13.4 million, yielding a net savings of ~$6.9M when patients were seen sooner. These estimated savings are very conservative, as costs associated from patients being unable to work and other health complications due to visual impairment are significantly higher.
With the current system, there either needs to be more ophthalmologists, increased funding to allow more surgeries per week, or an alternative space that can operate more efficiently with the existing resources. Publicly funded, privately offered services are becoming more and more prevalent as there is incentive for the organizations to be as efficient as possible, where our current hospital systems do not have this incentive. While this is a solution that has proven to more than double access to cataract surgery at a fraction of the existing costs, it needs to be approached with caution. Previous studies suggest that investor-owned centers lead to increased costs and decreased quality of care. Many centers in Canada are physician owned and operated; this may potentially be something that is implemented into legislature to ensure that the physician’s duty of care is involved to maintain the same standards of patient-centered care.
Publication Date: October 2022
Huang-Lang J. The true cost of hidden waiting times for cataract surgery in Australia. Public Health Research & Practice. 2022. doi: 10.17061/phrp31342116
Summary by: Andrew Robart