The waiting game: natural history of a cataract waiting list in New Zealand.
OBJECTIVE
To identify the demographic and visual function of patients on the reserve waiting list for cataract surgery at a large public hospital within New Zealand and to determine the ultimate outcome of those on a priority-based, rationed, health-care waiting list.


METHODS
Patients from a defined geographical population, placed on a reserve waiting list for possible cataract surgery, during the period January 1997 to March 2000, were invited to attend for further clinical assessment and asked to complete a visual assessment questionnaire.


RESULTS
Of 193 patients in the pilot study group who had been on the reserve waiting list for a mean of 18.2 +/- 11.6 months (range 0.1-62.7 months), only 94 (49%) were deemed suitable for, and subsequently underwent, surgery in the public sector. Forty-nine (25%) had undergone surgery earlier, the majority of these (84%) in the private sector. A further 23 (12%) patients were deceased, four (2%) declined surgery and in six (3%) cataract surgery was no longer indicated. The remaining 11 (6%) patients could not be traced. Patients still awaiting surgery had a mean age of 77.2 years (range 48-95 years). Fifty-four were women. Vision had deteriorated by a mean of 0.05 LogMAR units, from Snellen equivalent 6/30 at listing to 6/36, over this time.


CONCLUSIONS
Current methods of prioritization for cataract surgery are imperfect, as are the resources for performing adequate levels of cataract surgery. Analysis of a residual waiting list for cataract surgery highlights that the majority (51%) do not ultimately progress to cataract surgery in the public sector for a variety of reasons. During a mean waiting time of 1.5 years vision further deteriorates in this predominantly older population.
Riley
A F
AF
Discipline of Ophthalmology, University of Auckland, New Zealand.
Grupcheva
C N
CN
Malik
T Y
TY
Craig
J P
JP
McGhee
C N
CN
D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000175:diagnosis*; D002387:Cataract Extraction / Q000639:trends; D005260:Female; D015276:Health Care Rationing / Q000458:organization & administration; D006292:Health Priorities / Q000458:organization & administration; D006295:Health Resources / Q000458:organization & administration; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010865:Pilot Projects; D013222:State Medicine / Q000458:organization & administration; D014787:Vision Tests; D014850:Waiting Lists