Variability in the prioritization of patients for cataract extraction.
OBJECTIVE
The aim of this study was to compare time spent waiting for cataract extraction across various hospitals and to determine if it was influenced by severity of disease or patient characteristics.


METHODS
Ambispective cohort study. Clinical, sociodemographic, and health-related quality of life data were collected along with time spent on the waiting list.


METHODS
Twelve hospitals in four regions of Spain.


METHODS
A total of 4043 patients who were waiting for being intervened on cataracts in the participant centres were recruited prospectively. Exposition variables Priority was assigned retrospectively using a previously validated scoring system.


METHODS
Time spent on waiting list.


RESULTS
Statistically significant differences in time spent on the waiting list (P < 0.0001) were observed across the hospitals, even after adjusting for pathology, age, social dependency, laterality of the cataract and number of inappropriate interventions in each centre. Waiting time was not correlated with preintervention visual acuity, preintervention visual function measured by the VF-14 or priority score.


CONCLUSIONS
Allocation of cataract surgery does not appear to be correlated with the need for surgery or the likely benefit to be derived from it in the Spanish participant centres. The use of explicit and standardized priority criteria could provide a fairer, more rational way to manage waiting lists for this procedure and may help to reduce unnecessary variation on access to health care.
Hospital Galdakao-Usansolo, Vizcaya, Spain. susana.garciagutierrez@osakidetza.net
Susana
S
García Gutiérrez
Amaia
A
Bilbao
Jose María
JM
Beguiristain
Gemma
G
Navarro
Jesús
J
Martínez Tapias
Juan Antonio
JA
Blasco
José María
JM
Quintana
D000367:Age Factors; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D015276:Health Care Rationing / Q000379:methods*; D006739:Hospital Administration / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D013030:Spain; D014850:Waiting Lists