多伦多一家教学医院的眼科手术等待时间。

Hatch Wendy V, Trope Graham E

Department of Ophthalmology, University of Toronto, Toronto, Ont.

Can J Ophthalmol. 2004 Feb;39(1):31-7. doi: 10.1016/s0008-4182(04)80050-4.

BACKGROUND

Waiting times for eye surgery in Ontario have increased dramatically in recent years. We performed a study to compare the waiting times, the amount of operating time and the number of cases performed for various eye surgical procedures in 1999, 2000 and 2001 at a major Toronto teaching hospital.

METHODS

For 3 months (May, June and July) of 1999, 2000 and 2001, eye surgeons at the hospital reported how long their patients had to wait for surgery and how many patients they had waiting for surgery. The number of operating hours for eye surgery and the number of eye surgery cases in fiscal years 1999-2000, 2000-01 and 2001-02 were collected from a hospital database. Surgical procedures that were captured were cataract extraction, corneal transplantation, trabeculectomy (including phacotrabeculectomy), vitreoretinal surgery and adult strabismus surgery.

RESULTS

All surgeons responded to the survey. Median waiting times increased for all types of eye surgery between 1999 and 2001. The median wait for cataract extraction increased by 92%, from 3.0 to 5.8 months. For corneal transplantation the median wait doubled, from 5.5 to 11.0 months. The median wait for trabeculectomy increased by 60%, from 2.5 to 4.0 months. The median wait for vitreoretinal surgery almost tripled (191%), from 1.2 to 3.4 months. For adult strabismus surgery the median wait increased by 56%, from 8.0 to 12.5 months. Operating time was cut by over 1000 hours (from 5481 to 4434) from 1999-2000 to 2000-01 and then again, by 255 hours, from 2000-01 to 2001-02. Despite this, the number of surgical procedures performed decreased only slightly over the study period, from 4292 to 4099.

INTERPRETATION

The waiting times for all eye operations increased substantially between 1999 and 2001 at this Toronto teaching hospital. In addition, for each type of surgery the median waiting time was longer than the Ontario median, by 13% (cataract surgery) to 191% (vitreoretinal surgery). The fact that the number of cases performed decreased only slightly despite a dramatic decrease in operating time indicates that there was an increase in efficiency. Possible ways to reduce the long waits include implementing prioritization programs, increasing operating time and moving cataract surgery out of the hospital to a day surgical centre.

背景

近年来，安大略省眼科手术的等待时间大幅增加。我们开展了一项研究，以比较1999年、2000年和2001年在多伦多一家大型教学医院进行的各类眼科手术的等待时间、手术时长以及手术例数。

方法

在1999年、2000年和2001年的5月、6月和7月这3个月期间，该医院的眼科医生报告了他们的患者等待手术的时长以及等待手术的患者数量。从医院数据库中收集了1999 - 2000财年、2000 - 01财年和2001 - 02财年的眼科手术时长及眼科手术病例数。纳入统计的外科手术包括白内障摘除术、角膜移植术、小梁切除术（包括超声乳化小梁切除术）、玻璃体视网膜手术和成人斜视手术。

结果

所有外科医生均对调查做出了回应。1999年至2001年期间，各类眼科手术的中位等待时间均有所增加。白内障摘除术的中位等待时间增加了92%，从3.0个月增至5.8个月。角膜移植术的中位等待时间翻倍，从5.5个月增至11.0个月。小梁切除术的中位等待时间增加了60%，从2.5个月增至4.0个月。玻璃体视网膜手术的中位等待时间几乎增至三倍（191%），从1.2个月增至3.4个月。成人斜视手术的中位等待时间增加了56%，从8.0个月增至12.5个月。从1999 - 2000年到2000 - 01年，手术时长减少了1000多小时（从5481小时降至4434小时），然后从2000 - 01年到2001 - 02年又减少了255小时。尽管如此，在研究期间进行的外科手术例数仅略有下降，从4292例降至4099例。

解读

在这家多伦多教学医院，1999年至2001年期间所有眼科手术的等待时间大幅增加。此外，每种手术的中位等待时间均长于安大略省的中位等待时间，增幅为13%（白内障手术）至191%（玻璃体视网膜手术）。尽管手术时长显著减少，但手术例数仅略有下降，这表明效率有所提高。减少长时间等待的可能方法包括实施优先排序方案、增加手术时长以及将白内障手术从医院转移至日间手术中心。