Central LHIN Population-based planning CATARACTS · insertion of intraocular lens prosthesis with...

11

Central LHIN

Population-based planning

CATARACTS

January 9, 2006

22

Notice

• The purpose of this slide deck is for information only

• Data contained in this slide deck is not intended for planning purposes, and is only to provide insight into historical volumes of cataract procedures in the Central LHIN

• All projections contained in this slide deck are for discussion purposes only

33

Major Issues with Cataract Wait Times

• WT affects other procedures– Glaucoma and macular degeneration incidence linked to aging, will

increase with demographic trends

– Other “sub-specialty” procedures not significantly affected

– Paediatrics billed at same rate, but requires more time with patient

– Both institutions and physicians have incentive to focus on cataracts only

• What is need? What is a reasonable wait time?– Provincial expert panel deemed 19 weeks appropriate for “Class 3”

priority patients

– There is no clear level of impairment that distinguishes “need” among the Wait Times Office’s Priority IV cases

– Surgery referrals can get unreasonable for patients with low levels of functional impairment (e.g. 20/25 vision), but it is the physician/patient’s choice to proceed

44

Cataracts

The following discussion of data is based on a variety of sources

• MOH PHPDB data

• Other Assumptions

• Literature Review (Additions to existing)

• Data available online at Ontario Wait Times website

• Discussion with several key informants

– Local opthalmologist

– Wait Times office staff

– ICES, CIHI staff

55

Assumptions

• The 'utilization' model is a good starting point

• Need for service is defined in terms of historical health service utilization and is compared to the overall Ontario average

• Assume Ontario average is meeting the demands of the population

• No way of knowing whether the services provided went to the people who needed the services

66

Assumptions

• Historical patterns of care can not distinguish inappropriate use by patients / inappropriate demand by providers

• Historical patterns of utilization may not reflect the current reality, i.e.

• Emergence of new treatments

• Technology

• Changes in clinical practice guidelines

• Finally, this model is not population-based, so independent variables such as prevalence, population health, and socio-economic risk factors are not included

• All population projections are based on Central LHIN population (MOF) Projections

77

Literature ReviewSource Title Source Author Info captured Use in model

Ontario's Wait Time Strategy Nadia Surani (Lalani), Ontario

Wait Times Office

Hospital-specific wait times

Wait Times benchmarks

WTO plans

Case costs

Description of allocation criteria

General Strategy info

Wait times benchmarks

ICES Atlas, 1st and 2nd ed. -

Cataract Surgery (Chapter 4)

Chaim Bell et al., ICES Age-sex prevalence per 100,000

Age-sex adjusted rate of surgery

Other characteristics of prevalence

Parameters for model

Data validation

Reference documents

Report of the Cataract Surgery

Expert Panel

Provincial Expert Panel, Joann

Trypuc

Provincial panel recommendations

Priority/"need" classification criteria

Caveats to Wait Time Strategy

Recommended Median Wait

Time (RMWT)

Limitations/Assumptions

Cataracts in the 21st Century:

lessons from previous

epidemiologic research

McCarty, C.A., et al., Clinical

and Experimental Optometry

Cataract risk factors Parameters for model

• Includes analysis of embedded references in above sources

88

Central LHIN Historical review

99

Volume Report for Cataract Procedures Central LHIN

Sum of COUNT Patient ID#

Institution Name Base Vol. 2003 2004 2005 2006 2006 wt Grand Total

DON MILLS 400 326 401 464 468 68 1,659

HUMBER MEMORIAL 3272 3,011 3,196 3,767 4,200 928 14,174

MARKHAM 1231 972 1,244 1,456 1,521 290 5,193

NYGH -BRANSON 2200 1,675 2,320 2,725 2,850 650 9,570

SOUTHLAKE 1308 1,314 1,309 1,531 1,562 254 5,716

STEVENSON 117 113 494 563 446 1,170

YORK CENTRAL 1086 1,028 1,122 1,291 1,246 160 4,687

LHIN 8 Total 9614 8,326 9,705 11,728 12,410 2,796 42,169

Institution Name Base Vol. 2003 2004 2005 2006 2006 wt Grand Total

DON MILLS 4% 4% 4% 4% 4% 2% 4%

HUMBER MEMORIAL 34% 36% 33% 32% 34% 33% 34%

MARKHAM 13% 12% 13% 12% 12% 10% 12%

NYGH -BRANSON 23% 20% 24% 23% 23% 23% 23%

SOUTHLAKE 14% 16% 13% 13% 13% 9% 14%

STEVENSON 1% 0% 1% 4% 5% 16% 3%

YORK CENTRAL 11% 12% 12% 11% 10% 6% 11%

LHIN 8 Total 100% 100% 100% 100% 100% 100% 100%

CCP: Procedure

Code

2761

2762

2772

* Data Based on CCI Codes for Cataract Procedures (from Wait Times Group) is correlated R = .998

with the CCP Data (Extraction = 1.CL.89)

** Cataract Volumes are based on out patient procedures only.

Fiscal Year

Fiscal Year

INSERTION OF INTRAOCULAR LENS PROSTHESIS WITH CATARACT

EXTRACTION, ONE-STAGE

PHAKOFRAGMENTATION AND ASPIRATION OF CATARACT

REMOVAL OF SECONDARY MEMBRANOUS CATARACT

Intervention/Procedure Description

1010

Proportion of Cataract Procedures by Central LHIN Institutions

0%

5%

10%

15%

20%

25%

30%

35%

40%

Perc

en

t o

f T

ota

l P

roced

ure

s

DON MILLS HUMBER

MEMORIAL

MARKHAM NYGH -BRANSON SOUTHLAKE STEVENSON YORK CENTRAL

Hospital

Proportion of Procedures by Institution

2003 2004 2005 2006

1111

Volume of Cataract Procedures by Central LHIN Institutions

0

500

1000

1500

2000

2500

3000

3500

4000

4500

Perc

en

t o

f T

ota

l P

roced

ure

s

DON MILLS HUMBER

MEMORIAL

MARKHAM NYGH -BRANSON SOUTHLAKE STEVENSON YORK CENTRAL

Hospital

Volume of Procedures by Institution

Base Volume 2003 2004 2005 2006

1212

Ontario Utilization Model

1313

Use the above Historical Prevalence rates to determine age group and differences

between sexes. Based on above data Age group 11 is the point of focus for the

provincial needs based model.

Age Class Driving

Utilization

2005 Cataract Prevelance

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%

10.00%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

% Female

% Male

45

=>

50

50

=>

55

55

=>

60

60

=>

65

65

=>

70

70

=>

75

75

=>

80

80

=>

85

85

=>

90

90 +0

>

5

5

=>

10

10

=>

15

15

=>

20

20

=>

25

25

=>

30

30

=>

35

35

=>

40

40

=>

45

1414

Total Cataract Population - Central LHIN (Estimate)

Data 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Sum of 50 => 55 286 296 307 319 332 345 358 371 385 398 412 424 432 435

Sum of 55 => 60 525 562 599 629 641 656 675 699 724 753 782 810 839 869

Sum of 60 => 65 837 870 909 963 1,059 1,145 1,223 1,300 1,363 1,387 1,419 1,461 1,511 1,566

Sum of 65 => 70 1,568 1,616 1,655 1,692 1,742 1,805 1,875 1,955 2,067 2,264 2,441 2,602 2,761 2,892

Sum of 70 => 75 2,425 2,486 2,512 2,546 2,583 2,626 2,688 2,749 2,808 2,890 2,996 3,113 3,246 3,430

Sum of 75 => 80 2,615 2,685 2,770 2,860 2,929 2,991 3,041 3,070 3,108 3,152 3,204 3,282 3,360 3,437

Sum of 80 => 85 1,845 2,011 2,109 2,182 2,255 2,326 2,380 2,456 2,535 2,597 2,654 2,700 2,729 2,769

Sum of 85 => 90 677 702 764 850 932 1,016 1,094 1,148 1,190 1,232 1,273 1,307 1,354 1,403

Sum of 90 => 95 159 172 180 185 189 193 201 221 243 263 283 303 322 339

Total 10,938 11,401 11,805 12,227 12,660 13,103 13,536 13,969 14,425 14,936 15,464 16,003 16,555 17,140

Based on historical provincial rates, provincial rates were

applied to the above age groups to create a estimate for the

Central LHIN

Above data was used to determine the Provincial model based

on historical provincial procedural volumes. With the

assumption that everyone in the province (Large sample size)

who needed the procedure received it, can apply this rate to

Central LHIN to determine approximate need.

1515

•In 2005, all three “projections” are relatively equal•Historically, Central LHIN Hospitals were not meeting needs (Volume) of Central LHIN patients•Based on Hospital volumes, projected volume for 2016 > 30,000 procedures (current rate influenced by Wait Time reduction)•Based on Patient volumes, projected volume for 2016 > 25,000 procedures (current rate influenced by Wait Time reduction)•Ontario Utilization Model projects need in 2016 to be approximately 17,000 procedures (most reasonable)

Patient vs. Hospital Volumes

Cataracts in Central LHIN

-

5,000

10,000

15,000

20,000

25,000

30,000

35,000

2002 2004 2006 2008 2010 2012 2014 2016 2018

Years

# o

f P

roce

du

res

Total Central LHIN Residents

Total Central LHIN Hospitals

Central LHIN Model Projections

1616*Distance is calculated using a standard spherical trigonometry formula for calculating distance between Longitude and Latitude of two points.

Geographic Distance* Report for Central LHIN “Northern Hospitals”

Average weighted distance,

highlighted by the oval, is

calculated using the average

weighted distance of communities where people

traveled from to the institution

that preformed the cataract

procedure.

This distance is then multiplied

by the number of procedures

performed for residents from this community, and a weighted

average for each institution is the

result.

Community of origin is assigned

based on the community and the

postal code according to the

PCCF 2004 produced by Canada Post

-79.4492 44.06112 Distance (km) 12.02

Total 1531

NEWMARKET 419 27.4% -79.45965 44.05414 1.1 477.46

HOLLAND LANDING 257 16.8% -79.48967 44.10593 5.9 1,525.09

AURORA 159 10.4% -79.46918 43.99704 7.3 1,160.25

KESWICK 141 9.2% -79.4592 44.23829 20.1 2,828.30

BRADFORD 130 8.5% -79.57564 44.11199 11.6 1,503.62

BALDWIN 129 8.4% -79.32809 44.26658 30.1 3,886.03

RICHMOND HILL 45 2.9% -79.42968 43.88659 20.1 906.13

KING CITY 25 1.6% -79.54826 43.93708 15.9 397.36

MINESING 23 1.5% -79.82981 44.44911 52.7 1,211.80

UXBRIDGE 23 1.5% -79.12103 44.10835 30.7 706.39

ALLISTON 21 1.4% -79.85862 44.1493 34.1 716.17

NORTH YORK 17 1.1% -79.41823 43.75128 34.5 586.76

BARRIE 13 0.8% -79.69022 44.38236 40.5 526.84

INNISFIL 13 0.8% -79.57217 44.33014 31.5 408.92

BEAVERTON 10 0.7% -79.14009 44.43512 48.3 482.92

BRAMPTON 10 0.7% -79.75512 43.71086 46.0 459.86

STOUFFVILLE 8 0.5% -79.25119 43.98417 18.0 143.86

THORNHILL 8 0.5% -79.42425 43.82033 26.8 214.63

ANGUS 6 0.4% -79.87988 44.31814 44.6 267.85

-79.86902 44.15736 Distance (km) 26.33

Total 494 X Y

ALLISTON 113 22.9% -79.85862 44.1493 1.2 137.90

BRAMPTON 62 12.6% -79.75512 43.71086 50.4 3,127.35

SHELBURNE 51 10.3% -80.19886 44.10612 30.2 1,537.98

HOLLAND LANDING 46 9.3% -79.48967 44.10593 30.8 1,416.25

ANGUS 25 5.1% -79.87988 44.31814 17.9 447.13

ORANGEVILLE 25 5.1% -80.10391 43.9227 32.1 803.05

KESWICK 20 4.0% -79.4592 44.23829 33.9 677.24

GEORGETOWN 18 3.6% -79.91894 43.64857 56.7 1,020.11

NEWMARKET 16 3.2% -79.45965 44.05414 34.6 553.86

BOLTON 14 2.8% -79.77353 43.88185 31.5 441.68

AURORA 13 2.6% -79.46918 43.99704 36.6 475.16

BRADFORD 9 1.8% -79.57564 44.11199 23.9 215.39

INNISFIL 8 1.6% -79.57217 44.33014 30.4 243.55

MINESING 8 1.6% -79.82981 44.44911 32.6 260.53

NORTH YORK 8 1.6% -79.41823 43.75128 57.8 462.06

KING CITY 7 1.4% -79.54826 43.93708 35.4 248.01

RICHMOND HILL 7 1.4% -79.42968 43.88659 46.2 323.61

BALDWIN 6 1.2% -79.32809 44.26658 44.8 268.54

HUTTONVILLE 6 1.2% -79.80756 43.64105 57.6 345.47

SOUTHLAKE REGIONAL HEALTH CENTRE

STEVENSON MEMORIAL HOSPITAL 2005

1717

Geographic Distance* Report for Central LHIN “Southern Hospitals”

*Distance is calculated using a standard spherical trigonometry formula for calculating distance between Longitude and Latitude of two points.







procedure.





result.





DON MILLS SURGICAL UNIT 2005 -79.33804 43.72337 Distance (km) 6.17

Total 464

NORTH YORK 168 36.2% -79.41823 43.75128 7.1 1,200.49

SCARBOROUGH 105 22.6% -79.26207 43.7637 7.6 794.56

TORONTO 61 13.1% -79.36636 43.69882 3.6 216.65

EAST YORK 46 9.9% -79.33454 43.70247 2.3 107.62

THORNHILL 11 2.4% -79.42425 43.82033 12.8 140.83

MISSISSAUGA 8 1.7% -79.66968 43.59349 30.3 242.51

PICKERING 7 1.5% -79.10284 43.83602 22.6 158.50

-79.2599 43.87798 Distance (km) 10.86

Total 1456

MARKHAM 651 44.7% -79.29741 43.86502 3.3 2,169.22

STOUFFVILLE 148 10.2% -79.25119 43.98417 11.8 1,749.35

SCARBOROUGH 143 9.8% -79.26207 43.7637 12.7 1,816.01

RICHMOND HILL 82 5.6% -79.42968 43.88659 13.6 1,117.71

NORTH YORK 81 5.6% -79.41823 43.75128 20.0 1,620.08

THORNHILL 50 3.4% -79.42425 43.82033 14.6 732.24

UXBRIDGE 35 2.4% -79.12103 44.10835 30.9 1,081.51

PICKERING 24 1.6% -79.10284 43.83602 13.4 322.06

WHITBY 18 1.2% -78.94132 43.90183 25.6 461.65

GOODWOOD 17 1.2% -79.1782 44.04988 20.2 343.17

AURORA 14 1.0% -79.46918 43.99704 21.3 298.75

BALDWIN 14 1.0% -79.32809 44.26658 43.5 609.27

NEWMARKET 14 1.0% -79.45965 44.05414 25.3 353.70

EAST YORK 13 0.9% -79.33454 43.70247 20.4 265.19

ETOBICOKE 9 0.6% -79.53484 43.67007 31.9 287.47

TORONTO 9 0.6% -79.36636 43.69882 21.7 194.95

AJAX 8 0.5% -79.03199 43.85609 18.4 147.35

OSHAWA 8 0.5% -78.86367 43.90663 31.9 255.08

PORT PERRY 8 0.5% -78.95007 44.10483 35.3 282.70

HOLLAND LANDING 7 0.5% -79.48967 44.10593 31.3 219.00

MAPLE 7 0.5% -79.52296 43.85604 21.2 148.49

MISSISSAUGA 7 0.5% -79.66968 43.59349 45.6 319.36

BRAMPTON 6 0.4% -79.75512 43.71086 43.8 263.07

WELLAND 6 0.4% -79.24908 42.99305 98.3 589.98

WOODBRIDGE 6 0.4% -79.58217 43.8008 27.2 163.28

MARKHAM STOUFFVILLE HOSPITAL 2005

1818

Geographic Distance Report for a Central LHIN “Southern Hospital”








procedure.





result.





-79.44947 43.77253 Distance (km) 10.39

Total 2725

NORTH YORK 1140 41.8% -79.41823 43.75128 3.4 3,925.61

SCARBOROUGH 488 17.9% -79.26207 43.7637 20.1 9,808.80

TORONTO 280 10.3% -79.36636 43.69882 10.6 2,957.84

THORNHILL 178 6.5% -79.42425 43.82033 5.7 1,011.57

MARKHAM 146 5.4% -79.29741 43.86502 15.9 2,327.82

RICHMOND HILL 89 3.3% -79.42968 43.88659 12.8 1,136.71

YORK 70 2.6% -79.44923 43.67502 10.8 758.38

ETOBICOKE 51 1.9% -79.53484 43.67007 13.3 677.73

EAST YORK 37 1.4% -79.33454 43.70247 12.1 446.66

MISSISSAUGA 37 1.4% -79.66968 43.59349 30.6 1,132.20

WOODBRIDGE 31 1.1% -79.58217 43.8008 11.1 344.05

BRAMPTON 20 0.7% -79.75512 43.71086 25.5 509.50

PICKERING 16 0.6% -79.10284 43.83602 28.7 458.84

CONCORD 14 0.5% -79.51115 43.81326 6.7 93.86

AJAX 10 0.4% -79.03199 43.85609 34.7 347.36

MAPLE 9 0.3% -79.52296 43.85604 11.0 98.93

NEWMARKET 9 0.3% -79.45965 44.05414 31.3 281.70

WHITBY 7 0.3% -78.94132 43.90183 43.2 302.30

NORTH BAY 6 0.2% -79.44816 46.31644 282.7 1,695.93

-79.44992 43.87098 Distance (km) 11.57

Total 1291

RICHMOND HILL 540 41.8% -79.42968 43.88659 12.8 6,896.89

THORNHILL 207 16.0% -79.42425 43.82033 5.7 1,176.37

NORTH YORK 102 7.9% -79.41823 43.75128 3.4 351.24

MAPLE 94 7.3% -79.52296 43.85604 11.0 1,033.25

MARKHAM 67 5.2% -79.29741 43.86502 15.9 1,068.25

SCARBOROUGH 42 3.3% -79.26207 43.7637 15.1 632.88

CONCORD 28 2.2% -79.51115 43.81326 6.7 187.73

WOODBRIDGE 26 2.0% -79.58217 43.8008 11.1 288.55

AURORA 25 1.9% -79.46918 43.99704 25.0 624.87

TORONTO 16 1.2% -79.36636 43.69882 10.6 169.02

HUTTONVILLE 15 1.2% -79.80756 43.64105 32.3 483.89

NEWMARKET 13 1.0% -79.45965 44.05414 31.3 406.90

YORK 13 1.0% -79.44923 43.67502 10.8 140.84

BRAMPTON 12 0.9% -79.75512 43.71086 25.5 305.70

ETOBICOKE 11 0.9% -79.53484 43.67007 13.3 146.18

HOLLAND LANDING 11 0.9% -79.48967 44.10593 37.2 409.01

KING CITY 10 0.8% -79.54826 43.93708 19.9 199.23

MISSISSAUGA 9 0.7% -79.66968 43.59349 26.6 239.61

STOUFFVILLE 6 0.5% -79.25119 43.98417 28.4 170.25

YORK CENTRAL HOSPITAL 2005

NORTH YORK GENERAL HOSPITAL-

1919

Geographic Distance* Report for Central LHIN “Southern Hospitals”








procedure.





result.





HUMBER RIVER REGIONAL HOSP-HUMBER MEM 2005 -79.5097 43.70845 Distance (km) 8.63

Total 1964

NORTH YORK 696 35.4% -79.41823 43.75128 8.8 6,090.76

ETOBICOKE 404 20.6% -79.53484 43.67007 4.7 1,906.25

YORK 381 19.4% -79.44923 43.67502 6.1 2,329.84

WOODBRIDGE 116 5.9% -79.58217 43.8008 11.8 1,368.23

TORONTO 99 5.0% -79.36636 43.69882 11.6 1,144.76

MISSISSAUGA 42 2.1% -79.66968 43.59349 20.1 842.46

SCARBOROUGH 40 2.0% -79.26207 43.7637 20.8 832.24

MAPLE 33 1.7% -79.52296 43.85604 16.4 542.32

BRAMPTON 27 1.4% -79.75512 43.71086 19.7 532.26

THORNHILL 27 1.4% -79.42425 43.82033 14.2 383.30

CONCORD 14 0.7% -79.51115 43.81326 11.6 163.04

EAST YORK 14 0.7% -79.33454 43.70247 14.1 197.19

RICHMOND HILL 9 0.5% -79.42968 43.88659 20.8 187.27

BOLTON 6 0.3% -79.77353 43.88185 28.6 171.70

HOLLAND LANDING 6 0.3% -79.48967 44.10593 44.2 265.16

HUMBER RIVER REGIONAL HOSP-YORK-FINCH 2005 -79.52736 43.75513 Distance (km) 10.69

Total 1803

NORTH YORK 783 43.4% -79.41823 43.75128 10.1 7,871.86

WOODBRIDGE 223 12.4% -79.58217 43.8008 6.7 1,497.39

ETOBICOKE 176 9.8% -79.53484 43.67007 10.1 1,781.65

THORNHILL 114 6.3% -79.42425 43.82033 11.0 1,253.37

YORK 97 5.4% -79.44923 43.67502 10.9 1,056.32

TORONTO 51 2.8% -79.36636 43.69882 14.4 732.44

MAPLE 46 2.6% -79.52296 43.85604 11.2 516.04

BRAMPTON 42 2.3% -79.75512 43.71086 20.1 842.46

CONCORD 40 2.2% -79.51115 43.81326 6.6 263.52

SCARBOROUGH 35 1.9% -79.26207 43.7637 21.3 745.87

MISSISSAUGA 31 1.7% -79.66968 43.59349 21.3 660.06

RICHMOND HILL 31 1.7% -79.42968 43.88659 16.6 513.77

MARKHAM 13 0.7% -79.29741 43.86502 22.1 287.48

HOLLAND LANDING 9 0.5% -79.48967 44.10593 39.1 351.84

EAST YORK 8 0.4% -79.33454 43.70247 16.6 132.41

NEWMARKET 7 0.4% -79.45965 44.05414 33.7 235.63

SHELBURNE 6 0.3% -80.19886 44.10612 66.4 398.36

HUTTONVILLE 5 0.3% -79.80756 43.64105 25.8 129.16

2020

Distance Patients Travel in Central LHIN for Cataract Surgery

Current Multiple Hospital Sites (FY 2005 / 2006)

10 - 20 km30%

20 - 30 km 6%

30 - 40 km 9%

40 - 50 km 1%

50 - 60 km 4%

60+ km 2%

< 10 km48%

•78% Travel 20 km or less

•22% Travel 20 km or more

2121

10 - 20 km45%

20 - 30 km 7%

30 - 40 km 9%

40 - 50 km 1%

50 - 60 km 4%

60+ km 2% < 10 km32%

Distance Patients Travel in Central LHIN for Cataract Surgery if All at

Single Southern Site (FY 2005 / 2006)



2222

20 - 30 km 4%

30 - 40 km 1%

40 - 50 km 1%

50 - 60 km 0%

60+ km 0%

20 - 30 km 10%

30 - 40 km 7%

40 - 50 km 4%

50 - 60 km 3%

60+ km 5%

10 - 20 km61%

< 10 km33%

10 - 20 km24%

< 10 km47%

Distance Patients Travel in Central LHIN for Cataract Surgery if at a NorthernAND Southern Location (FY 2005 / 2006)

South

North





2323

10 - 20 km54%

20 - 30 km 6%

30 - 40 km 2%

40 - 50 km 1%

50 - 60 km 1%

60+ km 1%

< 10 km35%



Distance Patients Travel in Central LHIN for Cataract Surgery

Northern and Southern Site Combination (FY 2005 / 2006)

2424

CommunityDON MILLS

HUMBER

MEMORIAL

YORK-

FINCHMARKHAM

NYGH -

BRANSONSOUTHLAKE

STEVENSO

NYORK CENTRAL

Grand Total

2005

Grand Total 464 1964 1803 1456 2725 1531 494 1291 11728

NORTH YORK 168 696 783 81 1140 17 8 102 2995

MARKHAM 4 3 13 651 146 4 1 67 889

SCARBOROUGH 105 40 35 143 488 4 2 42 859

RICHMOND HILL 4 9 31 82 89 45 7 540 807

ETOBICOKE 5 404 176 9 51 4 11 660

THORNHILL 11 27 114 50 178 8 207 595

YORK 4 381 97 70 13 565

TORONTO 61 99 51 9 280 4 2 16 522

NEWMARKET 7 14 9 419 16 13 478

WOODBRIDGE 116 223 6 31 4 1 26 407

Top 10 Communities for Cataract Procedure Patient Volumes for Central LHIN

2525

Average Wait Times for Cataract Procedures

0

50

100

150

200

250

300

350

Sep-05 Oct-05 Nov-05 Dec-05 Jan-06 Feb-06 Mar-06 Apr-06 May-06 Jun-06 Jul-06 Aug-06 Sep-06

Fiscal Month (2 Month Average)

Avera

ge W

ait

Tim

e (

Days)

Ontario

Central LHIN

Reasonable Wait Time (Level IV) = 182 DaysSource: Presentation Ontario’s Wait Times Strategy to Central LHIN (March 23, 2006)

162 Days

225 Days

2626

Area Name Year

Total Central

LHIN (Male)

Total Central

LHIN (Female) Total ICES Rates

Central 2001 4,524 6,439 10,962

Central 2002 4,733 6,700 11,433

Central 2003 4,939 6,966 11,904

Central 2004 5,139 7,216 12,355

Central 2005 5,330 7,443 12,773

Central 2006 5,536 7,619 13,155

Central 2007 5,719 7,807 13,526

Central 2008 5,907 8,004 13,911

Central 2009 6,097 8,192 14,289

Central 2010 6,285 8,389 14,674

Central 2011 6,490 8,615 15,106

Central 2012 6,734 8,900 15,634

Central 2013 6,972 9,189 16,161

Central 2014 7,206 9,477 16,683

Central 2015 7,441 9,768 17,209

Central 2016 7,681 10,060 17,741

Age Sex Rates from ICES

Report

Excluded Income Data

from ICES as it had little

correlation with actual

rates.

As indicated by LHIN

Model, highly correlated

with age sex

ICES did not publish rates

for age less than 20 years

ICES

Rates Age 0 - 20 Age 20 - 64 Age 65-74 Age 75-84 Age 85+

Male - 284 3,540 7,428 6,028

Female - 262 4,824 8,500 5,047

Age and Sex specific rates of cataract surgery per 100,000 population in Ontario (2004 / 2005)

2727

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Fiscal Year

Vo

lum

e o

f C

ata

ract

Pro

ced

ure

s

ICES Needs Projections

Base Volume

Cataracts 9,614

Additional Funding Volume (WT)

Volume of Cataracts - Central LHIN Hospitals

Volume of Cataracts - Central LHIN Patients

Central LHIN Model Projections

Proposed Volume Cataracts (Dual Site 80 : 20 )

Central LHIN Strategy

So

uth

So

uth

So

uth

No

rth

No

rth

No

rth

Southern Collaborative

Northern Collaborative

Ontario Utilization Projections

2828

• ICES model and Original CLHIN model differ by 8.8% in 2003, and 3.5% in 2016

• There was a shortage of supply (12%) for CLHIN hospitals in 2003, have reduced % difference to 3% (almost at equilibrium) in 2005

• The additional funded volumes (through WT) are approximately equal to projected demand in 2006 / 2007 (12,410 ~ 12,227)

• Base Funded volumes (9,614) are significantly below the projected values from 2007 on

Observations

2929

Trends in Ophthalmological Procedures (2003 - 2005)

0

2000

4000

6000

8000

10000

12000

14000

2003 2004 2005

Fiscal Year

Vo

lum

e o

f P

roced

ure

s

2772

2730

2653

2250

2211

2854

2320

2399

2634

2531

2239

2269

2991

2209

2243

2422

Cataracts

Other Eye Procedures

Central LHIN

Central LHIN Population-based planning CATARACTS · insertion of intraocular lens prosthesis with...

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