Overall Time Spent by Clients from Entry to Exit and Associated Factors in Out-Patient Department of Jimma University Medical Center, South West Ethiopia

Abstract

Background: Hospitals in Ethiopia are on reform to increase quality of service they provide. The time client spent in the hospital is one of the fundamental importance as a measure of the quality of care because it gives information on the client satisfaction and provider’s success. The overall time refers to the length of time a patient spends in a health facility from the time of arrival at the facility to the time of exiting the facility. Waiting times arise as the result of the demand and supply imbalance. Even though, citizen charter is launched to provide timely services at Jimma University Medical Center in October 2016. The overall time spent by patients from entry to exit is not assessed. Objective: To assess the overall time spent by clients from entry to exit and associated factors in out- patient department of Jimma University Medical Center in South West Ethiopia 2018. Methods: This study was undertaken in Jimma University Medical Center by using Institution based cross-sectional study design from March15 to April15, 2018. The required sample size was obtained by using two sample t-test which was 249. The participants was selected from patients present at OPD, by using consecutive sampling technique. Data was collected, by using a time and motion tool coupled with interviewer administered structured questionnaire. Data was entered to epi data version 3.1 and export to SPSS version 20. Data was summarized by using descriptive statistics. Since the outcome variable was continuous so by using a linear regression analysis, factors associated with overall time was identified. Verbal consent was obtained from each study client at entry after providing of adequate information about the study. Result: - out of the total sample size (249), the response rate was 94.8% (236). Overall, patients spent a median time of 342.5 min in OPD of Jimma University Medical Center. Patients spent 12.7% of the total time as service time and 86% of time by waiting for care. The longest overall time was at the laboratory (170min), imaging (95min), other diagnostic units (84min) and examination (83min).The median(SD) overall time for pediatric and adult patient were 177.5 (153.9)min and 396(129.1)minutes respectively. The average overall time was increased by 52.03 (95%CI 21.65, 82.412)min, 4.65(95%CI 3.983, 5.324)min and 96.43(95%CI 52.076, 140.787) minutes as the patient was referred, increase of the number of patients at the queue by one unit and patients who had other diagnostic test performed respectively with P <0.005 & adjusted R 2 =0.522. Conclusion: Majority of the patient spent long overall time. Most time was spent on waiting for services especially at examination, laboratory and imaging units. This seems to be strongly associated with high patient load, absence of some services, being referred patients and poor response of professionals.