title: Cost-effectiveness of reducing wait times for cataract surgery in Ontario.
abstract: BACKGROUND
  Reducing wait times for cataract surgery is a priority in Ontario. However, no previous analysis has determined whether the extra treatment volumes required to reduce wait times are of good monetary value when compared with allocating those same financial resources to new programs, drugs, or technologies. The objective of the study was to use queuing models to determine the cost-effectiveness of reducing, to target levels, wait times for cataract surgery at the provincial level within 1 to 10 years by increasing treatment volumes.
  
  
  METHODS
  A cost-effectiveness analysis was performed by estimating the extra treatment volume required to reduce wait times using queuing model methodology. The cost of these extra treatments was obtained from Ontario provincial data. The incremental benefits of surgery are improvements in quality-adjusted life years (QALYs), and these values were obtained from the clinical literature. Incremental costs were compared with incremental benefits to determine an incremental cost-effectiveness ratio.
  
  
  RESULTS
  To reach the publicly stated target wait times, annual treatment volumes must increase by 4%. An extra increase in treatment volumes of 25,660 must also be provided for the transition period from the current wait time. The incremental cost-effectiveness ratio is $17,829 per QALY if the target wait time is achieved in 5 years, and this ratio is less than the common threshold for approval of new interventions, of $50,000 per QALY.
  
  
  CONCLUSIONS
  Increasing treatment volumes is a cost-effective way of reducing wait times.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, and the Programs for Assessment of Technology in Health Research Institute, St Joseph's Hospital, Hamilton, ON, Canada. hopkinr@mcmaster.ca
authors.forename: Robert B
authors.initials: RB
authors.lastname: Hopkins
authors.forename: Jean-Eric
authors.initials: JE
authors.lastname: Tarride
authors.forename: James
authors.initials: J
authors.lastname: Bowen
authors.forename: Gord
authors.initials: G
authors.lastname: Blackhouse
authors.forename: Daria
authors.initials: D
authors.lastname: O'Reilly
authors.forename: Kaitryn
authors.initials: K
authors.lastname: Campbell
authors.forename: Morgan
authors.initials: M
authors.lastname: Lim
authors.forename: Ron
authors.initials: R
authors.lastname: Goeree
mesh_terms: D002386:Cataract / Q000191:economics*; D002387:Cataract Extraction / Q000191:economics*; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D006292:Health Priorities; D006302:Health Services Research; D006801:Humans; D009864:Ontario; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D014850:Waiting Lists