The Impact of the COVID-19 Pandemic on Wait-Times for Ophthalmic Surgery in Ontario, Canada: A Population-Based Study

Michael Balas,1 Diana Vasiliu,2 Gener Austria,2 Tina Felfeli3– 5 1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 2Health System Intelligence Team, Health System Performance & Support Portfolio, Ontario Health, Toronto, ON, Canada; 3Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 4Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada; 5The Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, CanadaCorrespondence: Tina Felfeli, Toronto Western Hospital, 399 Bathurst Street, 6-East Room 432, Toronto, ON, M5T 2S8, Canada, Tel +1 647 678 1634, Fax +1 416 340 3459, Email tina.felfeli@mail.utoronto.caObjective: To investigate the effects of the COVID-19 pandemic on case volumes and wait-times for ophthalmic surgery in Ontario, Canada.Design: Population-based retrospective cohort study.Participants: Patients undergoing ophthalmic surgery in Ontario, Canada, from 2010 to 2021, collected from the Ontario Health Wait Times Information System (WTIS) database.Methods: The WTIS contains non-emergent surgical case volume and wait-time data for six ophthalmic subspecialty surgery types, three priority levels (low, medium, high) and 14 different regions in Ontario. Case volume and wait-times were compared between the COVID-19 pandemic (2020– 2021) and the preceding time period (2010– 2019) across all stratifications.Results: There was a significant decrease in case volumes and significant increase in wait-times across geographic regions, priority levels, and subspecialty surgeries from the pre-pandemic to pandemic period. Moreover, COVID-19 exacerbated pre-existing wait-time disparities between sexes, with females waiting 4.1 days longer than males overall to receive surgery in 2010– 2019 compared to waiting 8.8 days longer in 2020– 2021 (117% increase).Conclusion: These findings highligh