scholarly journals A study on waiting time of the OPD Patient in a Multispecialty Hospital

Author(s):  
Hiba Khan

Abstract: In this study, the OPD is defined as the hospital's department where patients received diagnoses and/or treatment but did not stay overnight. Patients spend substantial amount of time in the clinics, waiting for the services to be delivered by physicians and other allied health professionals. The degree to which health consumers are satisfied with the care received is strongly related to the quality of the waiting experience. The methodology for Data collection is a balance of primary and secondary sources. Primary outcome based upon personal visits to the hospital and hospital database. Secondary outcomes based upon the information collected through questionnaire. The present study was aimed at studying the waiting time of outpatient in the multi-speciality hospital. Our observation reveals that many patients face the difficulties in finding the various OPDs. On an average 10 minutes of waiting time outside the various O.P.D. and other departments.As the Hospital is coming up with the new hospital building, it is expected that infrastructural issues can be taken care during the planning and development stage. Assessment of patient’s waiting time and satisfaction is cost effective way for evaluation of heath care services. Keywords: OPD, Waiting Time, Patient management, Hospital management.

2018 ◽  
Vol 8 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Vinaytosh Mishra ◽  
Cherian Samuel ◽  
S. K. Sharma

Diabetes is rising like an epidemic in India. The prevalence of diabetes in India has reached an alarming level of 72.95 millions. The purpose of this article is to assess the relative importance of various health care service attributes in diabetes care. Our study uses secondary research and focus group discussion to identify the attributes of a diabetes specialty clinic. The attributes included in the questionnaire were the quality of the care provide by the health care givers, spend per visit, hospitalization expense, waiting time and the distance to the hospital. Conjoint analysis was used to assess the relative importance of the attributes. It was found that the hospital’s quality was the most important attribute while the distance to the hospital was the attribute with the least importance. Although the quality of the hospital is the most important criterion in selecting a hospital in diabetes care, factors like waiting time, spend per visit, and hospitalization expense play an important role in the selection. We assess the relative importance of these factors for the diabetic patients in India. The study is first of its kind and could help policy makers in designing better health care services in diabetes care.


Author(s):  
Dr. Ranjana Pandey Mishra ◽  
Dr. Ajay Kumar Mishra

The movement to include patient/client evaluations of care is growing as more providers/organizations realize that patient/client satisfaction measurement is a cost effective, noninvasive indicator of quality of care. Giving the patient/client an opportunity to voice their opinions about the care they receive can be seen as part of a broader commitment to public and patient/client participation in healthcare service planning and delivery. Purpose of the study is to analyze various factors which influence patient satisfaction or dissatisfaction with hospital services or care. Based on the feedback given by the patients or their attendants and to identify specific areas for improvement as well. Study is empirical in nature and data is collected through primary as well as secondary sources. Data is analyzed with the help of MS excel and statistical tools used are pie charts, tables etc. in present study it was concluded that room service and cleanliness corrections need to be made to enhance the comfort and satisfaction of the patients. There is a need to channelize the patients through the hierarchical levels of health care to prevent undue burden on the tertiary health facilities. Certain improvements are also needed in the waiting area by making it informative and comfortable.


2021 ◽  
Author(s):  
Nur Wahida Zulkifli

BACKGROUND The public opinion and experience on the health care services are crucial to provide valuable insight towards improving and strengthening the health care systems. OBJECTIVE This study aims to explore the public perspective regarding the quality of health care services rendered by the health care facilities in Malaysia. METHODS The snowballing strategy was used to reach the target through an online opinion poll with three open-ended questions on the strengths of the healthcare facilities, their expectation and suggestion for improvement along with the sociodemographic characteristic. Data were analysed using a thematic approach. RESULTS A total of 800 participants (68% of females and 32% of males) participated. Their responses were grouped into 5 main themes namely: (1) system; (2) input; (3) service delivery; (4) outputs; (5) outcomes. Public feel that they are respected and treated with care by the healthcare providers. However, most of the participants highlighted the issue of long waiting time when they visited healthcare facilities. In relation to this issue, they suggested the facilities to have more staff especially doctors to improve current service. CONCLUSIONS In conclusion, enhancing service delivery by reducing the waiting time, should be the main focus as viewed by the public. The quality of services provided would certainly be improved by having sufficient resources including healthcare workers.


2015 ◽  
Vol 19 (19) ◽  
pp. 1-222 ◽  
Author(s):  
Mark A Williams ◽  
Esther M Williamson ◽  
Peter J Heine ◽  
Vivien Nichols ◽  
Matthew J Glover ◽  
...  

BackgroundThe effectiveness of exercise for improving hand and wrist function in people with rheumatoid arthritis (RA) is uncertain.ObjectivesThe study aims were (1) to estimate the clinical effectiveness and cost-effectiveness of adding an optimised exercise programme for hands and upper limbs to standard care for patients with RA; and (2) to qualitatively describe the experience of participants in the trial with a particular emphasis on acceptability of the intervention, exercise behaviours and reasons for adherence/non-adherence.DesignA pragmatic, multicentred, individually randomised controlled trial with an embedded qualitative study. Outcome assessors were blind to group assignment and independent of treatment delivery.SettingSeventeen NHS trusts in England comprising 21 rheumatology and therapy departments.ParticipantsAdults with RA who had pain and dysfunction of the hands and/or wrists and had been on stable medication for at least 3 months. Patients were excluded if they were under 18 years old, had undergone upper limb surgery/fracture in the last 6 months, were on a waiting list for upper limb surgery or were pregnant.InterventionsUsual care or usual care plus an individualised exercise programme. Usual care consisted of joint protection education, general exercise advice and functional splinting if required. The exercise programme consisted of six sessions of strengthening and stretching exercises with a hand therapist, daily home exercises and strategies to maximise adherence.Main outcome measuresThe primary outcome was the Michigan Hand Outcome Questionnaire (MHQ) overall hand function subscale score at 12 months. Secondary outcome measures included the full MHQ, pain, health-related quality of life (Short Form questionnaire-12 items), impairment (grip strength, dexterity and range of motion) and self-efficacy. European Quality of Life-5 Dimensions, medication and health-care use were collected for the health economics evaluation. Follow-up was at 4 and 12 months post randomisation. Analysis was performed on an intention-to-treat basis.ResultsWe randomised 490 patients (244 to usual care, 246 to exercise programme). Compliance with the treatments was very good (93% of usual care participants and 75% of exercise programme participants completed treatment). Outcomes were obtained for 89% of participants at 12 months (222 for usual care, 216 for exercise programme). There was a statistically significant difference in favour of the exercise programme for the primary outcome at 4 and 12 months [mean difference 4.6 points, 95% confidence interval (CI) 2.2 to 7.0 points; and mean difference 4.4 points, 95% CI 1.6 to 7.1 points, respectively]. There were no significant differences in pain scores or adverse events. The estimated difference in mean quality-adjusted life-years (QALYs) accrued over 12 months was 0.01 greater (95% CI –0.03 to 0.05) in the exercise programme group. Imputed analysis produced incremental cost-effectiveness ratio estimates of £17,941 (0.59 probability of cost-effectiveness at willingness-to-pay threshold of £30,000 per QALY). The qualitative study found the exercise programme to be acceptable and highlighted the importance of the therapist in enabling patients to establish a routine and incorporate the exercises into their lives.ConclusionsThe results of the Strengthening And stretching for Rheumatoid Arthritis of the Hand trial suggest that the addition of an exercise programme for RA hands/wrists to usual care is clinically effective and cost-effective when compared with usual care alone. No adverse effects were associated with the exercise programme. The economic analysis suggests that the intervention is likely to be cost-effective.Study registrationCurrent Controlled Trials ISRCTN 89936343.Funding detailsThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 19. See the NIHR Journals Library website for further project information. This report has been developed in association with the NIHR Collaboration for Leadership in Applied Health Research and Care Oxford and the NIHR Biomedical Research Unit Funding Scheme. This project benefited from facilities funded through Birmingham Science City Translational Medicine Clinical Research and Infrastructure Trials Platform, with support from Advantage West Midlands.


2015 ◽  
Vol 19 (73) ◽  
pp. 1-124 ◽  
Author(s):  
Willem Kuyken ◽  
Rachel Hayes ◽  
Barbara Barrett ◽  
Richard Byng ◽  
Tim Dalgleish ◽  
...  

BackgroundIndividuals with a history of recurrent depression have a high risk of repeated depressive relapse/recurrence. Maintenance antidepressant medication (m-ADM) for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to m-ADM. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce the risk of relapse/recurrence compared with usual care but has not yet been compared with m-ADM in a definitive trial.ObjectivesTo establish whether MBCT with support to taper and/or discontinue antidepressant medication (MBCT-TS) is superior to and more cost-effective than an approach of m-ADM in a primary care setting for patients with a history of recurrent depression followed up over a 2-year period in terms of preventing depressive relapse/recurrence. Secondary aims examined MBCT’s acceptability and mechanism of action.DesignSingle-blind, parallel, individual randomised controlled trial.SettingUK general practices.ParticipantsAdult patients with a diagnosis of recurrent depression and who were taking m-ADM.InterventionsParticipants were randomised to MBCT-TS or m-ADM with stratification by centre and symptomatic status. Outcome data were collected blind to treatment allocation and the primary analysis was based on the principle of intention to treat. Process studies using quantitative and qualitative methods examined MBCT’s acceptability and mechanism of action.Main outcomes measuresThe primary outcome measure was time to relapse/recurrence of depression. At each follow-up the following secondary outcomes were recorded: number of depression-free days, residual depressive symptoms, quality of life, health-related quality of life and psychiatric and medical comorbidities.ResultsIn total, 212 patients were randomised to MBCT-TS and 212 to m-ADM. The primary analysis did not find any evidence that MBCT-TS was superior to m-ADM in terms of the primary outcome of time to depressive relapse/recurrence over 24 months [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.67 to 1.18] or for any of the secondary outcomes. Cost-effectiveness analysis did not support the hypothesis that MBCT-TS is more cost-effective than m-ADM in terms of either relapse/recurrence or quality-adjusted life-years. In planned subgroup analyses, a significant interaction was found between treatment group and reported childhood abuse (HR 1.89, 95% CI 1.06 to 3.38), with delayed time to relapse/recurrence for MBCT-TS participants with a more abusive childhood compared with those with a less abusive history. Although changes in mindfulness were specific to MBCT (and not m-ADM), they did not predict outcome in terms of relapse/recurrence at 24 months. In terms of acceptability, the qualitative analyses suggest that many people have views about (dis)/continuing their ADM, which can serve as a facilitator or a barrier to taking part in a trial that requires either continuation for 2 years or discontinuation.ConclusionsThere is no support for the hypothesis that MBCT-TS is superior to m-ADM in preventing depressive relapse/recurrence among individuals at risk for depressive relapse/recurrence. Both treatments appear to confer protection against relapse/recurrence. There is an indication that MBCT may be most indicated for individuals at greatest risk of relapse/recurrence. It is important to characterise those most at risk and carefully establish if and why MBCT may be most indicated for this group.Trial registrationCurrent Controlled Trials ISRCTN26666654.FundingThis project was funded by the NIHR Health Technology Assessment programme and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula and will be published in full inHealth Technology Assessment; Vol. 19, No. 73. See the NIHR Journals Library website for further project information.


2020 ◽  
Author(s):  
Andualem Firdie ◽  
Alemnew Maru ◽  
Abdulahi Deriye ◽  
Amare Assefa ◽  
Abdi Bedassa ◽  
...  

Abstract Introduction: Maternal satisfaction on delivery services is an important indicator for assessment of the quality of care. Quality of delivery care is the degree to which maternal health services for individuals and populations increase the likelihood of timely and appropriate treatment for the purpose of achieving desired outcomes. The use of services and outcomes are the result not only of the provision of care but also of women’s experience of that care. Therefore, investigating women’s experience or satisfaction on delivery care is of paramount importance to enhance the services utilization. Methods: An institution based cross-sectional study design was used. Data were collected using structured and pretested questionnaire from 403 mothers who were recruited by simple random sampling technique. Multivariable binary logistic regression was used to identify variables associated with maternal satisfaction on delivery services on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p – value less than 0.05. Results: The current study found that 78.2%, 65.5%, 64.3%, 49.9% and 44.7% of the mothers who gave birth at the University of Gondar teaching and referral hospital were satisfied on physicians’ communication, health care services, physicians’ attitude, privacy and sanitation condition of the health institution respectively. The overall satisfaction of mothers on delivery services was found to be 65.5%. Maternal satisfaction was statistically associated with diploma and above education [AOR = 0.29, 95% CI = (0.13, 0.66)]; secondary and/or primary education [AOR = 0.42, 95% CI = (0.20, 0.90)]; Antenatal care (ANC) follow-up in the current pregnancy [AOR = 4.47, 95% CI = (1.77, 11.27)] and short waiting time [AOR =1.85, 95% CI = (1.19, 2.88)].Conclusion: This study revealed that the overall satisfaction of mothers on delivery service was found to be suboptimal. Physicians’ communication, health care services and physicians’ attitude were areas where the highest proportion of mothers satisfied. On the other hand, the highest proportion of mothers was dissatisfied on sanitation condition. Educational status, ANC follow-up and waiting time were found to be statistically associated with maternal satisfaction on delivery services.


Author(s):  
Catherine Needham ◽  
Kerry Allen ◽  
Kelly Hall

Shifts to independent delivery of health and social care services has led to increased numbers of micro-enterprises. Could these tiny organisations with just 5 or fewer employees be the best way of delivering cost-effective health and social care services in the context of decreased budgets and increased demands? What size is 'just right' for a care provider? This book explores size as an independent variable in care services, comparing outcomes and value for money across micro, small, medium and large organisations. Using interviews and surveys with 108 people using services and careers in 27 case study organisations it focuses on the contribution micro-enterprise can make to the care sector. Findings indicate that the quality of service provided by small organisations does support the assumption of an affinity between being small and being personalised. Small and micro-enterprises can deliver more personalised services, particularly in the home. They also offer better outcomes than larger providers for a similar cost. However stability can be a problem for micro-enterprises, particularly those that employ staff and need to have a relatively consistent financial turnover. The Care Act 2014 creates a conducive policy environment for micro-enterprise, as local authorities must stimulate a diverse local market and facilitate personalisation of services. However the challenges of austerity are a powerful counterweight, discouraging the sorts of innovative and experimentation which would allow micro-enterprise to thrive.


2021 ◽  
Vol 13 (1) ◽  
pp. 112-121
Author(s):  
Suman Shumshere Thapa ◽  
Indira Paudyal ◽  
Pratibha Lama Joshi ◽  
Kalpana Singh ◽  
Anil Parajuli

Glaucoma is a leading cause of blindness worldwide. The diagnosis and management of glaucoma is especially difficult in the developing countries. Lack of cost effective screening strategies, low income, low rates of literacy and inadequate infrastructures and human resources for eye care services are the obstacles for delivering glaucoma service. Majority of people with glaucoma in developing countries usually present at an advanced stage at the time of diagnosis; which negatively affects their quality of life. Further research, proper allocation of resources and collaborative effort by blindness prevention programs will hopefully provide new evidences on cost effective ways to screen and manage glaucoma in the future. This article aims to highlight the burden of glaucoma and ways to address the challenges in developing countries.


2014 ◽  
Vol 23 (01) ◽  
pp. 49-55
Author(s):  
L. C. Hofbauer ◽  
D. Felsenberg ◽  
M. Amling ◽  
A. Kurth ◽  
P. Hadji

SummaryIt is important to understand compliance and persistence with medication use in the clinical practice of osteoporosis treatment. The purpose of this work is to describe the “intravenous ibandronate versus oral alendronate” (VIVA) study, a non-interventional trial to assess the compliance and persistence of osteopenic postmenopausal women with treatment via weekly oral alendronate or intravenous ibandronate (Bonviva®) every three months.4477 patients receiving ibandronate 3 mg i. v. quarterly and 1491 patients receiving alendronate 70 mg orally weekly were included in the study. Matched pairs of 901 subjects in each group were also generated. Matching was performed on the basis of age, body mass index, fracture history at study inclusion, prior treatment with bisphosphonates and the number of concomitant disorders. Secondary outcome measures of osteoporosis related fractures, mobility restriction and pain, analgesia, quality of life questionnaires as well as attitudes to medications were assessed. The primary outcome parameters of compliance and persistence will be tracked in these subjects.At baseline, the entire collectives differed significantly on body weight (less in ibandronate group), duration since osteo - porosis diagnosis (longer in ibandronate), and incidence of prior osteoporotic fracture (higher in ibandronate group). The matched-pairs differed only on mobility restriction and quality of life (both worse in ibandronate group).The results from the VIVA study trial will provide scientific rationale for clinical recommendations in the pharmacological treatment of postmenopausal osteoporosis.


Sign in / Sign up

Export Citation Format

Share Document