Patient waiting time and associated factors at the assessment center, general out-patient department, Mulago Hospital Uganda

Abstract

Introduction: Waiting time remains an important indicator for quality health services and in order to ensure timely access to quality outpatient services, an objective evaluation is needed to pinpoint which services cause delays in service delivery. Objectives of the study: To quantify waiting time, identify sections with bottlenecks and factors associated with waiting time of services offered at the Assessment center Mulago. Methods: A cross sectional study using a time and motion tool couples with and structured questionnaire was conducted. A real-time data and patient views from of 401 patients were obtained and 5 key informant interviews were conducted with the staff. Overall patient waiting time was calculated, sections with bottlenecks identified and factors associated with delays in accessing care identified using a linear regression model. Results: Overall, patients spent a median time of 346 minutes in assessment center. Patient spent 5% of this time with health worker and 95% of this time waiting for care. The longest overall waiting time was at the pharmacy (123min), X-ray (105min) and registration (66min) sections accounting for 24%, 30% and 14% of their time respectively. Average overall waiting time was shorter for patients arriving after 8am but still longer for those arriving after 11am compared to those who came before 8am. Average overall waiting time was longer for patients reporting on a Friday than compared to Monday. The average overall waiting time tends to increase by 3.4, 3.1 and 4.6 minutes for every additional patient in the registration triage and pharmacy queues respectively. Conclusion: Most time is spent waiting for services especially at registration and pharmacy section. This seems to be strongly associated with long queues due to high patient load, particular days and late patient arrivals. A system that limits the number of patient reporting to OPD especially those with minor illness is needed to not only reduce patient load but to also improve quality of outpatient care provided at the outpatient department.