Patients' maximum acceptable waiting time for cataract surgery: a comparison at two time-points 7years apart.

Abstract

To evaluate the maximum acceptable waiting time (MAWT) of cataract patients and assess the determinants of their perception of MAWT at two time-points 7years apart. 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. The mean MAWT was 3.2months in both periods, whereas the actual waiting time decreased significantly by 1.7months (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 <3months 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 3months (p=0.002 and p=0.023). 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.