Cataract surgery rates more than doubled in Ontario: demand still exceeds supply

01/08/2007

Cataract surgery rates in Ontario more than doubled between 1994 and 2005, but there is still more of a demand for the surgery than availability, a new study from the Institute for Clinical Evaluative Sciences (ICES) shows.

“Advances in surgical technique, a growing and aging population, and changing lifestyle expectations have all led to greater demand for cataract surgery in Ontario,” said Dr. Chaim Bell, ICES adjunct scientist and senior author of the study.

“However, despite large increases in annual surgeries over the past decade through improved efficiency and additional funding, the fact that we continue to have lengthy wait times for cataract surgery in Ontario suggests that the demand has exceeded the supply. It’s important that we examine our cataract surgery rates to help determine the most appropriate target rate, to ensure that those in greatest need receive this procedure.”

In this study, investigators identified patients who had cataract surgery in Ontario between April 1994 and March 2005. They calculated cataract surgery rates for all ages, as well as the overall and regional rates per 100,000 residents aged 65 years and older.

The results show:

The number of cataract surgery procedures in Ontario for all ages more than doubled between fiscal 1994/95 and 2004/05, from 54,365 to 111,396 procedures. Those aged 65 years and older accounted for approximately 81% of all cataract surgeries in the province, doubling from 43,818 to 90,179 over the decade.
Procedure rates for Ontarians aged 65 years and older per 100,000 residents rose by 66%, from 3,408 in 1994/95 to 5,650 in 2004/05.
Regional rates varied considerably across the province. In 2004/05, the region with the highest rate of cataract surgeries per 100,000 residents over 65 years of age was more than 1.5 times the rate seen in the region with the lowest rate.

“Cataract surgery rates are expected to continue to rise as a result of specific funding allocations for additional procedures intended to decrease wait times for surgery across the province and country,” said Dr. Bell.

“In addition to helping policy makers and health planners determine appropriate target rates for cataract surgery, our findings can be used as benchmarks for regional programs or for monitoring program expansion, which are current political initiatives in our own and in other jurisdictions.”

The study “A 10-year population-based cohort analysis of cataract surgery rates in Ontario” is in the August 2007 issue of the Canadian Journal of Ophthalmology.

Author affiliations: ICES (Drs. Cernat and Bell); Department of Ophthalmology and Vision Sciences (Dr. Singer and Dr. Hatch), Department of Medicine (Dr. Bell), and Department of Health Policy, Management and Evaluation (Dr. Bell), University of Toronto; University Health Network (Dr. Singer and Dr. Hatch); Department of Medicine and Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital (Dr. Bell).

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.