title: Impact of a national system for waitlist prioritization: the experience with NIKE and cataract surgery in Sweden.
abstract: OBJECTIVE
  To evaluate waiting times for first-eye cataract surgery in Sweden following widespread adoption of the Nationell Indikationsmodell for Kataraktextraktion (NIKE) tool for prioritizing patients for cataract surgery.
  
  
  METHODS
  Waiting times for all first-eye cataract surgeries in Sweden in 2009-2011 were identified from the Swedish National Cataract Register. Waiting times were compared according to demographic, clinical and NIKE indication group for surgery. Multivariate logistic regression modelling was used to determine factors associated with waiting times less than the 3-month Government guarantee period.
  
  
  RESULTS
  There were 141,070 first-eye cataract surgeries in 2009 to 2011; an annual increase of around 6%. Over the study period, mean waiting times decreased across all NIKE groups. The proportion waiting <3 months for surgery also increased across all NIKE groups. Surgery within 3 months of waitlisting was more likely for patients with a NIKE 1 indication classification (most need for surgery), in later years, male patients, younger patients and patients with a preoperative visual acuity in the better eye worse than 6/24.
  
  
  CONCLUSIONS
  Prioritizing patients for cataract surgery using NIKE reduces waiting times for those with the greatest need.
authors.affiliation: Eye and Vision Epidemiology Research Group, Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, WA, AustraliaEyeNet Sweden, Blekinge Hospital, Karlskrona, SwedenDepartment of Clinical Sciences and Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden.
authors.forename: Jonathon Q
authors.initials: JQ
authors.lastname: Ng
authors.forename: Mats
authors.initials: M
authors.lastname: Lundström
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000592:standards*; D005260:Female; D006292:Health Priorities / Q000592:standards*; D006301:Health Services Needs and Demand / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D009885:Ophthalmology / Q000592:standards*; D018579:Patient Selection; D012042:Registries; D018434:Sickness Impact Profile; D013548:Sweden; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities; D014850:Waiting Lists
keywords: cataract surgery; equity; health services; prioritization; waiting times