Role of patient choice in influencing wait time for cataract surgery

Abstract Objective To assess the role of patient choice in influencing wait time for cataract surgery. Design Cross-sectional study. Participants 496 patients aged ≥40 years presenting to Kensington Eye Institute in Toronto for cataract surgery in 2010–2011. Methods Patients were invited to complete a self-administered questionnaire about their experience with wait time management, sociodemographics, and satisfaction with wait time. Differences in median wait time were statistically tested with the Wilcoxon test. Factors associated with declining the first available surgery date were analyzed with prevalence ratios (PR) and 95% confidence intervals (CIs). Results Overall, 90% of patients had surgery within 21 weeks; 16% experienced a wait longer than the pan-Canadian benchmark (16 weeks). The median wait time was 8 weeks. Altogether, 21% declined the first available surgery date. Major reasons included planned travel/holidays (35%), family responsibilities (14%), and earlier date became available (13%). Excluding those with “earlier date became available” and “cancellation by surgeon,” the proportion declining the first available date decreased to 18%. In multivariate analysis, individuals with a college/university education were 60% more likely to decline (PR 1.6, 95% CI 1.0–2.5). Conversely, individuals living alone were 50% less likely to decline (PR 0.5, 95% CI 0.3–0.9). The median wait time was 2.5 weeks longer for those who declined than for those who accepted (8.5 vs 6 weeks; p = 0.02). Conclusions One in 5 patients declined the first available date for cataract surgery in 2010–2011 in Toronto. As wait time for cataract surgery improves, patient choice seems to play a greater role in influencing the wait.