How prompt do patients receive orthopaedic care in tertiary health facilities in resource-constrained setting?
Main Article Content
Abstract
Background: The timeliness domain of quality plays prominent role in assessing the quality of emergency medical care and trauma care. Prompt services reduce morbidity, mortality, man-hour and resource wastages in the health system. Delays in accessing care are common in health facilities in most low- and middle-income countries.
Aim: To determine the waiting time before orthopaedic services were received at the various units by ambulatory adults at the University of Port Harcourt Teaching Hospital.
Methods: This time-flow study for receipt of orthopaedic services by ambulatory patients in the University of Port Harcourt Teaching Hospital used a longitudinal study design. Responses from consecutively sampled patients were analyzed using Statistical Package for Social Sciences (SPSS) version 23 for windows.
Results: A total of 442 patients gave consent and were recruited into the study but only 430 patients gave complete responses to the questionnaires giving a response rate of 97.3%. The mean age was 38.5 +/-14.8 years. The mean time from when a patient was referred to see the orthopaedic doctor to the commencement of orthopaedic consultation was 2.6 days; while that for receiving radiologic services after seeing the orthopaedic doctor was 1. 9 days. At the doctor’s station, 50 % of patient waited for 33.34minutes before orthopaedic service was rendered. Visit status, gender and educational qualification showed strong association with waiting times at the records, nursing station and doctor’s station respectively.
Conclusion: Waiting time is an important indicator to the quality of care received and reducing it is key to improving care quality.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The journal grants the right to make small numbers of printed copies for their personal non-commercial use under Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License.
References
World Health Organization. The World health report 2000. Health systems : improving performance.Geneva, Switzerland: World Health Organization,2000.
Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press, 2001.
Agency for Healthcare Research and Quality. 2004 National Healthcare Quality Report. AHRQ Publication No. 05-0013. Rockville, MD: Agency for Healthcare Research and Quality, 2004. Available at: http://www.qualitytools.ahrq.gov/qualityreport/browse/browse.aspx?id=5077.
Jatulis DE, Bundek NI, Legorreta AP. Identifying predictors of satisfaction with access to medical care and quality of care. Am J Med Qual 1997;12(1):11–18.
Meng YY, Jatulis DE, McDonald JP, Legorreta AP. Satisfaction with access to and quality of healthcare among medicare enrollees in a health maintenance organization. West J Med 1997;166(4):242–247.
Merritt Hawkins & Associates. Survey of Physician Appointment Wait Times. 2004. Available at: http://merritthawkins.com/pdf/mha2004waitsurv.pdf. Accessed June 26, 2005.
Murray M, Berwick DM. Advanced access: reducing waiting and delays in primary care. JAMA 2003;289(8):1035–1040.
Conner-Spady BL, Sanmartin C, Johnston GH, McGurran JJ, Kehler M, Noseworthy TW. The importance of patient expectations as a determinant of satisfaction with waiting times for hip and knee replacement surgery. Health Policy 2011;101(3):245–252.
Löfvendahl S, Eckerlund I, Hansagi H, Malmqvist B, Resch S, Hanning M. Waiting for orthopaedic surgery: factors associated with waiting times and patients’ opinion. Int J Qual Health Care 2005;17(2):133–140.
O'Malley MS, Fletcher SW, Fletcher RH, Earp JA. Measuring patient waiting time in a practice setting: a comparison of methods. J Ambul Care Manage 1983; 6(3):20-27.
Thompson AE, Anisimowicz Y, Miedema B, Hogg W, Wodchis WP, Aubrey-Bassler K. The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study. BMC Fam Pract 2016; 17: 38.
Rossiter CE, Raynolds FA. (1968). Automatic monitoring of the time waited in an outpatient clinic. Med Care 1968; 1:218–225.
Maxwell S, Maljanian R, Horowitz S, Pianka MA, Cabrera Y, Greene J. Effectiveness of reminder systems on appointment adherence rates. J Health Care Poor Underserved 2001; 12(4):504–514.
Ofili AN, Ofovwe CE. Patient's assessment of efficiency of services at a teaching hospital in a developing country. Ann Afr Med 2005; 4(4):150–153.
Anderson R, Barbara A, Feldman S. What patients want: a content analysis of key qualities that influence patient satisfaction. J Med Pract Manage 2007; 22(5): 255–261.
Singh H, Haqq ED, Mustapha N. Patients' perception and satisfaction with health care professionals at primary care facilities in Trinidad and Tobago. Bull World Health Organ 1999; 77(4):356-360.
Oche M, Adamu H. Determinants of patient waiting time in the general outpatient department of a tertiary health institution in north Western Nigeria. Ann Med Health Sci Res 2013; 3(4): 588–592.
Mazaheri Habibi MR, Abadi FM, Tabesh H, Vakili-Arki H, Abu-Hanna A, Eslami S. Evaluation of patient satisfaction of the status of appointment scheduling systems in outpatient clinics: identifying patients' needs. J Adv Pharm Technol Res 2018; 9(2): 51–55.
Starfield B. Primary care: balancing health needs, services and technology. New York: Oxford University Press, 1998.
Haggerty JL, Reid RJ, Feeman GK, Starfield BH, Adair CE, McKendry R. Continuity of care: a multidisciplinary review. BMJ 2003;327(7425):1219–1221.
Mayo-Smith M, Radwin LE, Abdulkerim H, Mohr DC. Factors associated with patient ratings of timeliness of primary care appointments. J Patient Exp 2020;7(6):1203-1210.
Edgman-Levitan S, Shaller D, Campione J, Zema C, Abraham JR, Yount N, et al. The CAHPS ambulatory care improvement guide: practical strategies for improving primary care. New Haven, CT: Yale School of Public Health, 2017.
Hutchison B, Østbye T, Barnsley J, Stewart M, Mathews M, Campbell MK, et al. Patient satisfaction and quality of care in walk-in clinics, family practices and emergency departments: the Ontario walk-in clinic study. CMAJ 2003;168(8):977–983.
Fortney JC, Burgess JFJ, Bosworth HB, Booth BM, Kaboli PJ. A re-conceptualization of access for 21st century healthcare. J Gen Intern Med 2011;26(Suppl 2):639–647.
Quinn M, Robinson C, Forman J, Krein SL, Rosland AM. Survey instruments to assess patient experiences with access and coordination across health care settings: available and needed measures. Med Care 2017;55 Suppl 7:S84–S91.