Health Technology Research in Brazil
Anais Online do "Health Technology Research in Brazil: Challenges for the New Decade"

Purpose: Due to the coronavirus disease 2019 (COVID-19) pandemic, ophthalmic surgeries were canceled causing an increase in the waiting list. Our objective is to estimate the size of the ophthalmic surgical backlog during COVID-19 in Ontario, Canada, and suggest resource planning methods.
Method: We developed an individual-level microsimulation model, using a stochastic approach to simulate a dynamic cohort of patients who were waiting for surgery at the start of the pandemic. New patients were added to the waiting list patient with representative characteristics for ophthalmic surgery required and urgency level. Outcomes were accrued over a time horizon of 3 years, and the cycle length of the model was denominated in days.
The primary outcomes of the study were the number of patients awaiting ophthalmic surgery per month and the time to surgery (number of days on the wait list) based on the subspecialty surgeries including vitreoretinal, glaucoma, cornea, cataract, oculoplastics, and strabismus surgery, and level of urgency (urgent, semi-urgent and non-urgent) and priority (defined by the waiting time).
The simulation was begun on March 15, 2020 with an ending date on January 1, 2023. For the pandemic phase (base case) representing the backlog created as a result of the COVID-19 pandemic shutdowns in the province, the number of available resources for November 2019 to October 2020 from the Wait Time Information System database was used.
The model was calibrated for different time horizons to estimate the resources required to clear the backlog of patients accumulated on the waitlist since the pandemic on March 15, 2020.
Result: As of March 15, 2020, there were 55,306 patients on the waitlist in the province of Ontario and awaiting non-emergency ophthalmic surgery. The number of surgical procedures performed between March to May 2020 declined from 45,794 to 8,466 (82% decrease). The full results will be available for presentation at the conference.
Discussion: The magnitude of the backlog for ophthalmic surgery as a result of COVID-19 has important implications for patient care and healthcare providers in Ontario. The scenarios simulated in this model will be essential in resource planning for the surgical backlog recovery in other jurisdictions.