Overall time spent by clients from entry to exit and associated factors in out-patient departments in public hospitals of Jimma Zone southwest, Ethiopia.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 21 01 2022
accepted: 13 12 2023
medline: 7 3 2024
pubmed: 7 3 2024
entrez: 7 3 2024
Statut: epublish

Résumé

The overall time refers to the amount of time a patient spends in a health care facility, from the time he or she enters to the time he or she leaves. As a result of the imbalance between supply and demand, waiting times occur. Ethiopian hospitals are being reformed to improve the quality of care they provide. The time a patient spends in the hospital is one of the most important indicators of quality of care, as it provides insight into customer satisfaction and provider success. However, the overall time patients spend in hospitals was not studied. The study aimed to assess the overall time spent by clients from entry to exit and associated factors in the outpatient departments of Jimma zone hospitals. An institution-based cross-sectional study was conducted. Patients from outpatient units at Jimma zone public hospitals participated in the study from March 15 to May 17, 2018. Data were collected using a time and motion tool coupled with an interviewer-administered structured questionnaire on 249 samples. Participants in the study were selected using the consecutive sampling method. Overall time, in terms of waiting and service times at each section unit, and the relationship of socio-demographic and clinical factors with overall time was the main outcome variables. Data were analyzed using descriptive and linear regression analysis. Simple linear regression analysis was used to determine the relationship between the dependent and explanatory variables. Variables were considered significantly associated with the overall time if they had a p-value of less than 0.05 at the 95% confidence interval (CI). The overall response rate was 94.8%. Overall, patients spent a median time of 342.5 minutes. Patients spent 12.7% of the total time as service time and 86% of the time waiting for care. The longest overall times were spent in the laboratory (170 minutes), imaging (95 minutes), other diagnostic units (84 minutes) and examination (83 minutes). The average overall time was increased by 52.03 minutes (95%CI 21.65, 82.412), 4.65 minutes (95%CI 3.983, 5.324), and 96.43 minutes (95%CI 52.076, 140.787) when the patient was referred, the number of patients at the queue was increased by one unit, and patients who had other diagnostic tests performed respectively with P <0.005 &adjusted R2 = 0.522. The majority of patients stayed for a longer period. Most time was spent waiting for services, particularly in the examination, laboratory, and imaging units. This is strongly related to high patient load, an absence of some services, being referred patients, and patients who had other diagnostic tests. To reduce the number of patients in the queues, hospitals should work hand in hand with the Ministry of Health to enforce policies that are understood and adopted by all workers in the lower healthcare facilities. And hospital administrators are working to strengthen the triaging system to screen patients with minor illnesses. This is because most patients with minor illnesses queue with those with more complicated illnesses. Finally, we recommend that researchers conduct further research on service quality.

Sections du résumé

BACKGROUND BACKGROUND
The overall time refers to the amount of time a patient spends in a health care facility, from the time he or she enters to the time he or she leaves. As a result of the imbalance between supply and demand, waiting times occur. Ethiopian hospitals are being reformed to improve the quality of care they provide. The time a patient spends in the hospital is one of the most important indicators of quality of care, as it provides insight into customer satisfaction and provider success. However, the overall time patients spend in hospitals was not studied.
OBJECTIVE OBJECTIVE
The study aimed to assess the overall time spent by clients from entry to exit and associated factors in the outpatient departments of Jimma zone hospitals.
METHODS METHODS
An institution-based cross-sectional study was conducted. Patients from outpatient units at Jimma zone public hospitals participated in the study from March 15 to May 17, 2018. Data were collected using a time and motion tool coupled with an interviewer-administered structured questionnaire on 249 samples. Participants in the study were selected using the consecutive sampling method. Overall time, in terms of waiting and service times at each section unit, and the relationship of socio-demographic and clinical factors with overall time was the main outcome variables. Data were analyzed using descriptive and linear regression analysis. Simple linear regression analysis was used to determine the relationship between the dependent and explanatory variables. Variables were considered significantly associated with the overall time if they had a p-value of less than 0.05 at the 95% confidence interval (CI).
RESULT RESULTS
The overall response rate was 94.8%. Overall, patients spent a median time of 342.5 minutes. Patients spent 12.7% of the total time as service time and 86% of the time waiting for care. The longest overall times were spent in the laboratory (170 minutes), imaging (95 minutes), other diagnostic units (84 minutes) and examination (83 minutes). The average overall time was increased by 52.03 minutes (95%CI 21.65, 82.412), 4.65 minutes (95%CI 3.983, 5.324), and 96.43 minutes (95%CI 52.076, 140.787) when the patient was referred, the number of patients at the queue was increased by one unit, and patients who had other diagnostic tests performed respectively with P <0.005 &adjusted R2 = 0.522.
CONCLUSION AND RECOMMENDATIONS CONCLUSIONS
The majority of patients stayed for a longer period. Most time was spent waiting for services, particularly in the examination, laboratory, and imaging units. This is strongly related to high patient load, an absence of some services, being referred patients, and patients who had other diagnostic tests. To reduce the number of patients in the queues, hospitals should work hand in hand with the Ministry of Health to enforce policies that are understood and adopted by all workers in the lower healthcare facilities. And hospital administrators are working to strengthen the triaging system to screen patients with minor illnesses. This is because most patients with minor illnesses queue with those with more complicated illnesses. Finally, we recommend that researchers conduct further research on service quality.

Identifiants

pubmed: 38451898
doi: 10.1371/journal.pone.0296630
pii: PONE-D-22-02050
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0296630

Informations de copyright

Copyright: © 2024 Walle et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Zebader Walle (Z)

Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Frehiwot Worku (F)

Department of Public Health, St. Paul Millennium Medical College, Addis Ababa, Ethiopia.

Yibeltal Sraneh (Y)

Department of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia.

Dejenie Melese (D)

Department of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia.

Tilahun Fufa (T)

Department of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia.

Elias Ali Yesuf (EA)

Department of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
CIHLMU Center for International Health, Ludwig-Maximilians-Universität, München, Germany.

Gete Berihun (G)

Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

Classifications MeSH