title: Patients' maximum acceptable waiting time for cataract surgery: a comparison at two time-points 7 years apart.
abstract: OBJECTIVE
  To evaluate the maximum acceptable waiting time (MAWT) of cataract patients and assess the determinants of their perception of MAWT at two time-points 7 years apart.
  
  
  METHODS
  In 2007 (prior to the transformation of our cataract service to a day case unit) and 2014, 500 consecutive patients with cataract were asked to fill in a preoperative questionnaire addressing their MAWT to undergo cataract surgery. The patients' visual impairment (VF-14 score), education and social status were evaluated.
  
  
  RESULTS
  The mean MAWT was 3.2 months in both periods, whereas the actual waiting time decreased significantly by 1.7 months (p < 0.001). Patients who had self-noted visual impairment were nearly four times (p < 0.001) more likely to accept only an MAWT of <3 months in 2007. In both periods, patients with a VF-14 score lower than the mean were more likely to accept a shorter MAWT (p = 0.002 and p = 0.034). Living together with children or having relatives close by was associated with a greater acceptance of an MAWT longer than 3 months (p = 0.002 and p = 0.023).
  
  
  CONCLUSIONS
  Reducing the actual mean waiting time had no impact on the mean MAWT. Patients with poor tolerance of waiting had greater self-reported difficulty with vision. Social support was also a strong predictor from the patients' perspective. The VF-14 score had a greater impact than clinical visual acuity (VA) testing. Considering the implementation of standards for waiting lists, objective criteria to guarantee a transparent system should be taken into account.
authors.affiliation: Department of Ophthalmology, KH Hietzing, Vienna, Austria.|Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Vienna, Austria.
authors.forename: Birgit
authors.initials: B
authors.lastname: Weingessel
authors.affiliation: Department of Ophthalmology, KH Hietzing, Vienna, Austria.|Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Wahl
authors.affiliation: Department of Ophthalmology, KH Hietzing, Vienna, Austria.|Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Vienna, Austria.
authors.forename: Pia V
authors.identifier: http://orcid.org/0000-0003-1823-5644
authors.initials: PV
authors.lastname: Vécsei-Marlovits
mesh_terms: D000368:Aged; D001317:Austria / Q000453:epidemiology; D002386:Cataract / Q000453:epidemiology*; D002387:Cataract Extraction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014792:Visual Acuity; D014850:Waiting Lists
keywords: cataract surgery; patients’ perspective; visual impairment; waiting time