The Impact of the COVID-19 Pandemic on Wait-Times for Ophthalmic Surgery in Ontario, Canada: A Population-Based Study

Michael Balas; Diana Vasiliu; Gener Austria; Tina Felfeli

doi:10.2147/OPTH.S409479

The Impact of the COVID-19 Pandemic on Wait-Times for Ophthalmic Surgery in Ontario, Canada: A Population-Based Study

Clin Ophthalmol. 2023 Jun 26:17:1823-1831. doi: 10.2147/OPTH.S409479. eCollection 2023.

Authors

Michael Balas¹, Diana Vasiliu², Gener Austria², Tina Felfeli^{3

4

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Affiliations

¹ Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
² Health System Intelligence Team, Health System Performance & Support Portfolio, Ontario Health, Toronto, ON, Canada.
³ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
⁴ Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada.
⁵ The Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.

Abstract

Objective: To investigate the effects of the COVID-19 pandemic on case volumes and wait-times for ophthalmic surgery in Ontario, Canada.

Design: Population-based retrospective cohort study.

Participants: Patients undergoing ophthalmic surgery in Ontario, Canada, from 2010 to 2021, collected from the Ontario Health Wait Times Information System (WTIS) database.

Methods: The WTIS contains non-emergent surgical case volume and wait-time data for six ophthalmic subspecialty surgery types, three priority levels (low, medium, high) and 14 different regions in Ontario. Case volume and wait-times were compared between the COVID-19 pandemic (2020-2021) and the preceding time period (2010-2019) across all stratifications.

Results: There was a significant decrease in case volumes and significant increase in wait-times across geographic regions, priority levels, and subspecialty surgeries from the pre-pandemic to pandemic period. Moreover, COVID-19 exacerbated pre-existing wait-time disparities between sexes, with females waiting 4.1 days longer than males overall to receive surgery in 2010-2019 compared to waiting 8.8 days longer in 2020-2021 (117% increase).

Conclusion: These findings highlight the impact of the COVID-19 pandemic on ophthalmic surgical wait times in Ontario. Cataract, strabismus and oculoplastic surgeries, the Waterloo Wellington, Central, and South East regions of Ontario, and those with female sex had the greatest relative increases in wait-times during the pandemic.

Keywords: ophthalmology; surgery; wait time.

Grants and funding

Tina Felfeli has received grants from the Vanier Canada Graduate Scholarship, Canada Graduate Scholarship-Masters, the Vision Science Research Program, Fighting Blindness Canada, and Postgraduate Medical Education Research Awards as part of postsecondary research funding. The funding organizations had no role in the design or conduct of this research.