Médecine communautaire et éducation à la santé

Abstrait

Timespan at a Specialized Outpatient Clinic of the National Referral Hospital, Uganda

Esther BS, Fredrick N, Martin M, Peace B, Gideon A, Daniel K, Edrisa M

Background: Waiting time is the total time a patient spends while seeking care at the health facility service points on a particular visit from arrival to the exit. Waiting time is of emerging global concern because patients spend substantial amounts of time in clinics waiting for services to be delivered. Prolonged waits affect the consumers in terms of productivity, satisfaction, utilization of healthcare services, retention and adherence to the programme but additionally has effects on the healthcare /service providers working and waiting environment. Waiting time and patient satisfaction constitute the waiting experience which is an important indicator of the quality of services offered by hospitals. The Institute of Medicine (IOM) recommends that, at least 90% of patients should be seen within 30 min of their scheduled appointment time. Drug refills without complaints, scheduled follow-up visits should be attended to within one hour after arrival. This is, however, not the case in most developing countries, as several studies have shown that patients spend 2-4 hours in the outpatient departments before seeing the doctor though long clinic times have been reported in both developed and developing countries. The consequences of long waiting times are evidenced by the increased proportions of patients who leave without being seen.

Methods: The time patients spend at this specialized outpatient clinic of the National Referral Hospital in Kampala, Uganda is unknown. The clinic visit duration have not been measured; its associated factors have not been examined and the uninterrupted movement of patients, known as patient flow has not been evaluated at this specialized outpatient care facility. This Diabetic outpatient clinic has to objectively measure visit time that can accurately determine the different service point times during service delivery. Some of the solutions or recommendations out of the study could be evaluated with follow-up studies to explore their impact on time. Finally, the hospital and eventually the National strategic planners or policy makers will depend on the study findings and suggestions or recommendations during their work.

This study aimed at evaluating the service time and its predictive factors at the specialized outpatient clinic of a National Referral hospital in Uganda. A total of 319 consenting adult patients were recruited into the study using a systematic sampling technique.

Results: The age of the respondents ranged from 20 to 77 years, with a mean age of 51.1 years. The majority of the study participants, 68.97%, were above 45years old and female respondents accounted for 66.46%. Most of the study participants, 92.79%, spent more four hours. The visit duration ranged from 120 minutes to 600 minutes with the mean visit duration 393.3 minutes. Gender (P=0.006), Hypertension status P= (0.046) were found to be significantly associated with total patient waiting time or visit duration.

Conclusion: It is necessary for health facilities in Uganda to schedule patient appointments, address human resource gaps in order to improve the doctor-to-patient ratio and reduce clinic and waiting time.