-Automatic translation

The dashboard is based on:

• Submitted data from medical institutions on the number of people waiting for selected surgical procedures, number of completed operations and waiting times for surgery. This refers to the time that elapses between an individual being assessed for a specific surgical need and the time that the operation is performed.

• A central database of waiting list information for knee and hip replacements.

The last data recall was in September 2023, so the latest values on the dashboard show the number of people waiting for surgery in September 2023 and the number of people who completed the operation between 1 September 2022 and 31 August 2023. An exception to this is the number of people waiting for hip and knee replacement surgery, which is set for October 2023. This is because there was a delay in programming the calculated waiting time in a central waiting list system, which was completed in October. However, the number of completed joint replacement operations applies for the same period from 1 September 2022 to 31 August 2023. Data from Handlæknastöðin was updated on 15 November due to a registration error.

As the text below mentions, the data returns from the surgery sites are considerably lacking. The dashboard will be updated once data is received.

Cataract surgeries

The number of patients awaiting cataract surgery at Landspítali University Hospital has steadily grown in recent years while operations have declined. When questioned, managers at Landspítali University Hospital say that they had planned more operations, but staffing, equipment malfunctions and the extent of emergency services explain why this has not been achieved. No data from Lentis on the number of people waiting have been received. The Directorate of Health´s request for submission of data has been repeated. An enquiry has also been sent to the Akureyri Hospital regarding the waiting time for cataract surgery. It is unclear if, and if so, how many people are registered on the waiting list at more than one surgery site.

Breast reduction

The number of people waiting for breast reduction surgery at Landspítali University Hospital has increased significantly in recent years, and operations have declined. In response to a question to Landspítali, managers stated that this is due to a lack of operating room space. However, they are seeking ways to increase the number of such operations, both outside the hospital and inside. Data from Klíníkin for these procedures has not been received in the last recalls. The Directorate of Health´s request for submission of data has been repeated.

Excision or ablation of aberrant pathway or focus of heart

The number of people waiting for excision or ablation of an aberrant pathway or focus of the heart has steadily increased since January 2021, with 40% of those waiting for such a procedure in September waiting more than 12 months. When questioned, managers of cardiac services at Landspítali University Hospital say that a lack of funding and facilities causes that as many operations as would be desirable have not been performed. Although efforts have been undertaken at the hospital to improve patient flow and increase the number of procedures, the waiting list has not been shortened. The need for this type of surgery has increased; good results from such surgery lead to more requests and may require reoperation of 20-40% of patients. Managers at Landspítali expect that it will be possible to continue to increase the number of operations and that waiting times will be acceptable by the end of 2025.

Joint replacements

Last spring, Iceland Health made agreements with Handlæknastöðin in Glæsibær and Klíníkin to perform 700 knee and hip replacement surgeries in 2023 (Icelandic) to work on the waiting lists of the public health institutions that perform joint replacement surgeries. The Directorate of Health was involved in this project by sending a questionnaire to individuals who had waited the longest according to data in a central waiting list database and met the conditions of the contract. At the end of October, 1,643 individuals had received the questionnaire. Of those, 1,167 responded (roughly 70%). The answers shed light on the fact that persons who have completed surgery may still be registered as waiting for surgery elsewhere. This causes an over-count of people waiting for knee and hip replacement surgery in the data published by the Directorate of Health. The Office is already working on improvements. Answers to the questionnaire also showed that a third did not want to undergo surgery at another surgery site.

Data on the number of completed operations clearly show that knee and hip replacements during the period covered by the recall, 1 September 2022 to 31 August 2023, are significantly higher than in previous periods, especially knee replacements. Further data on joint replacement operations, in particular, can be seen in the dashboard, which is updated monthly.

More information:
Kjartan Hreinn Njálsson, assistant to the Medical Director of Health
kjartan.h.njalsson@landlaeknir.is