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

Abstract

Michael Balas,1 Diana Vasiliu,2 Gener Austria,2 Tina Felfeli3– 5 1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 2Health System Intelligence Team, Health System Performance & Support Portfolio, Ontario Health, Toronto, ON, Canada; 3Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 4Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada; 5The Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, CanadaCorrespondence: Tina Felfeli, Toronto Western Hospital, 399 Bathurst Street, 6-East Room 432, Toronto, ON, M5T 2S8, Canada, Tel [phone], Fax [phone], Email [email protected]: 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

Keywords

• ophthalmology
• surgery
• wait time;