Hospital Services for Ill Patients in the Middle-Belt Geopolitical Zone,Nigeria: Patient’s Waiting Time and Level of Satisfaction

Abstract

An important parameter in the assessment of quality health care lies on patient satisfaction. Despite concerted efforts to improve health-care services, patient satisfaction coupled with the quality of hospital care at disposal remain a significant challenge in Nigeria. The purpose of the study was to determine the perception on factors associated with prolonged waiting time and patient satisfaction at the outpatient department of Ibrahim Badamasi Babangida Specialist Hospital in Nigeria. A mixed-method research was utilized. Questionnaire was administered on 95 outpatients, and a focus group discussion (FGD) was held with eight participants. Statistical analysis was utilized to determine the association between dependent and independent variables. Data from FGD were analyzed with NVivo 10. The overall hospital satisfaction was found to be 75.8% among the study population. There was a significant inverse relationship between the level of satisfaction with the doctor and employment status and educational level and a significant direct relationship between the level of satisfaction with the doctor and appointment status and type of visits. The results of FGD show that patients were satisfied with the neatness of the hospital, doctor’s professionalism, and patient–doctor relationship. Dissatisfaction was with extended patient waiting time and the small size infrastructure of the hospital, inefficient handling of patient files by nurse aids, and thoroughness of the physicians. The results showed that majority of the patients were dissatisfied with the waiting time for consultation in the hospital. In other words, consultation time positively correlated with the level of patient satisfaction. To improve the overall patient satisfaction, the waiting time for consultation should be reduced significantly.

Keywords

illness patients satisfaction waiting time

Get full access to this article

View all access options for this article.

References

Adekanye

A. O.

Adefemi

S. A.

Okuku

A. G.

Onawola

K. A.

Adeleke

I. T.

James

J. A.

(2013) Patients’ satisfaction with the healthcare services at a north-central Nigerian tertiary hospital. Nigerian Journal of Medicine 22: 218–224.

Ajayi

(O. 2002) Patients’ waiting time at an outpatient clinic in Nigeria—Can it be put to better use? Patient Education and Counseling 47: 121–126.

Ameh

Sabo

Oyefabi

(2013) Application of queuing theory to patient satisfaction at a tertiary hospital in Nigeria. Nigerian Medical Journal: Journal of the Nigeria Medical Association 54: 64–67.

Anderson

R. T.

Camacho

F. T.

Balkrishnan

(2007) Willing to wait? The influence of patient wait time on satisfaction with primary care. BMC Health Services Research 7: 31–35.

Asefa

Kassa

Dessalegn

(2014) Patient satisfaction with outpatient health services in Hawassa University Teaching Hospital, Southern Ethiopia. Journal of Public Health 6: 101–110.

Bamgboye

Erinoso

Ogunlesi

(1992) The waiting time at the children’s emergency room, University College hospital, Ibadan. Nigerian Journal of Paediatrics 19: 9–14.

Barlow

G. L.

(2002) Auditing hospital queuing. Managerial Auditing Journal 17: 397–403.

Barua

Esmail

Jackson

(2014) The effect of wait times on mortality in Canada, Calgary, AB: Fraser Institute, Centre for Health Policy Studies.

Becker

Douglass

(2008) The ecology of the patient visit: Physical attractiveness, waiting times, and perceived quality of care. The Journal of Ambulatory Care Management 31: 128–141.

10.

Bielen

Demoulin

(2007) Waiting time influence on the satisfaction-loyalty relationship in services. Managing Service Quality: An International Journal 17: 174–193.

11.

Billing

Newland

Selva

(2007) Improving patient satisfaction through information provision. Clinical & Experimental Ophthalmology 35: 439–447.

12.

Bolton

S. C.

(2002) Consumer as king in the NHS. International Journal of Public Sector Management 15: 129–139.

13.

Bowers

M. R.

Swan

J. E.

Koehler

W. F.

(1994) What attributes determine quality and satisfaction with health care delivery? Health Care Management Review 19: 49–55.

14.

Brian

(2002) The content of a primary care population: Including the patient agenda. Journal of the American Board of Family Practice 16(4): 279–283.

15.

Carrus

Corbett

Khandelwal

(2010) A hospital-wide strategy for fixing emergency-department overcrowding. McKinsey Quarterly ▪: 1–12.

16.

Cleary

P. D.

McNeil

B. J.

(1988) Patient satisfaction as an indicator of quality care. Inquiry 23: 25–36.

17.

Conrad

(2013) Patient waiting time and associated factors at the assessment center, general out-patient department Mulago Hospital Uganda, Kampala, Uganda: Makerere University.

18.

Cox

(1993) Stress research and stress management: Putting theory to work, Sudbury, ON, Canada: HSE Books, pp. 61.

19.

Creswell

J. W.

Plano Clark

V. L.

(2007) Designing and conducting mixed methods research, 2nd ed. Thousand Oaks, CA: Sage Publications, Inc.

20.

Creswell

J. W.

Plano Clark

V. L.

Gutmann

M. L.

Hanson

W. E.

(2003) Advanced mixed methods research designs. In: Tashakkori

Teddlie

(eds) Handbook of mixed methods in social and behavioral research, Los Angeles, CA: Sage Publications, Inc, pp. 209–240.

21.

Datuk

IR M.S.

Johari Dato Mohd Ghazali

Hazilah Abd Manaf

Hassan Asaari Abdullah

Abu Bakar

Salikin

Ismefariana Wan Ismail

(2011) Hospital waiting time: The forgotten premise of healthcare service delivery? International Journal of Health Care Quality Assurance 24: 506–522.

22.

Derlet

R. W.

Richards

J. R.

(2000) Overcrowding in the nation’s emergency departments: Complex causes and disturbing effects. Annals of Emergency Medicine 35: 63–68.

23.

Derlet

R. W.

Richards

J. R.

(2002) Emergency department overcrowding in Florida, New York, and Texas. Southern Medical Journal 95: 846–849.

24.

Dinesh

Singh

Nair

Remya

(2013) Reducing waiting time in outpatient services of large university teaching hospital—A six sigma approach. Management in Health 17(1): 31–37.

25.

Dos Santos

L. M.

Stewart

Rosenberg

N. M.

(1994) Pediatric emergency department walk-outs. Pediatric Emergency Care 10: 76–78.

26.

Fenton

J. J.

Jerant

A. F.

Bertakis

K. D.

Franks

(2012) The cost of satisfaction: A national study of patient satisfaction, health care utilization, expenditures, and mortality. Archives of Internal Medicine 172: 405–411.

27.

Gregg

M. B.

(2008) Field epidemiology, New York, NY: Oxford University Press.

28.

Hall

(2013) Patient flow: Reducing delay in healthcare delivery Vol. 206: New York, NY: Springer Science & Business Media.

29.

Hall

Belson

Murali

Dessouky

(2006) Modeling patient flows through the healthcare system. In: Hall

(ed.) Patient flow: Reducing delay in healthcare delivery, New York, NY: Springer, pp. 1–44.

30.

Haraden

Resar

(2004) Patient flow in hospitals: Understanding and controlling it better. Frontiers of Health Services Management 20: 3–15.

31.

E. T. L.

(2014) Improving waiting time and operational clinic flow in a tertiary diabetes center. BMJ Quality Improvement Reports 2: u201918. w1006.

32.

Idowu

A. P.

Adeosun

O. O.

Williams

K. O.

(2014) Dependable online appointment booking system for NHIS outpatient in Nigerian Teaching Hospitals. International Journal of Computer Science & Information Technology 6(4): 59–73.

33.

Iliyasu

Abubakar

Lawan

Gajida

(2010) Patients’ satisfaction with services obtained from Aminu Kano Teaching Hospital, Kano, Northern Nigeria. Nigerian Journal of Clinical Practice 13(4): 371–378.

34.

Johnson

Myers

Wineholt

Pollack

Kusmiesz

A. L.

(2009) Patients who leave the emergency department without being seen. Journal of Emergency Nursing 35: 105–108.

35.

Johnson

R. B.

Onwuegbuzie

A. J.

Turner

L. A.

(2007) Toward a definition of mixed methods research. Journal of Mixed Methods Research 1: 112–133.

36.

Kelarijani

S. E. J.

Jamshidi

Heidarian

A. R.

Khorshidi

(2014) Evaluation of factors influencing patient satisfaction in social security hospitals in Mazandaran province, North of Iran. Caspian Journal of Internal Medicine 5: 232–234.

37.

Lambe

Washington

D. L.

Fink

Laouri

Liu

Fosse

J. S.

Asch

S. M.

(2003) Waiting times in California’s emergency departments. Annals of Emergency Medicine 41: 35–44.

38.

Liptak

G. S.

Super

D. M.

Baker

Roghmann

K. J.

(1985) An analysis of waiting times in a pediatric emergency department. Clinical Pediatrics 24: 202–209.

39.

Lowry, F. (2009). Massachusetts’ universal healthcare coverage reveals serious shortage of primary care physicians. Medscape Today. http://www.medscape.com/viewarticle/710200.

40.

Megbelayin

E. O.

Ibeinmo

Kurawa

M. S.

Babalola

Y. O.

(2013) Pre-consultation waiting time in a Nigerian public Eye facility—A source of patient dissatisfaction. Standard Research Journal of Medicine and Medical Sciences 1: 1–5.

41.

Meier-Kriesche

H.-U.

Port

F. K.

Ojo

A. O.

Rudich

S. M.

Hanson

J. A.

Cibrik

D. M.

Kaplan

(2000) Effect of waiting time on renal transplant outcome. Kidney International 58: 1311–1317.

42.

Michael

Schaffer

S. D.

Egan

P. L.

Little

B. B.

Pritchard

P. S.

(2013) Improving wait times and patient satisfaction in primary care. Journal for Healthcare Quality 35: 50–60.

43.

Murray

Berwick

D. M.

(2003) Advanced access: Reducing waiting and delays in primary care. JAMA 289: 1035–1040.

44.

Naumann

Miles

J. A.

(2001) Managing waiting patients’ perceptions: The role of process control. Journal of Management in Medicine 15: 376–386.

45.

Net

Sermsri

Chompikul

(2007) Patient satisfaction with health services at the out-patient department clinic of Wangmamyen community hospital, Sakeao province, Thailand. Journal of Public Health 5: 34–42.

46.

Oche

Adamu

(2014) Determinants of patient waiting time in the general outpatient department of a tertiary health institution in North Western Nigeria. Annals of Medical and Health Sciences Research 3: 588–592.

47.

Ogden

Bavalia

Bull

Frankum

Goldie

Gosslau

Vasant

(2004) “I want more time with my doctor”: A quantitative study of time and the consultation. Family Practice 21: 479–483.

48.

Olusina

A. K.

Ohaeri

J. U.

Olatawura

M. O.

(2002) Patient and staff satisfaction with the quality of in-patient psychiatric care in a Nigerian general hospital. Social Psychiatry and Psychiatric Epidemiology 37: 283–288.

49.

O’Malley

M. S.

Fletcher

S. W.

Fletcher

R. H.

Earp

J. A.

(1983) Measuring patient waiting time in a practice setting: A comparison of methods. The Journal of Ambulatory Care Management 6: 20–27.

50.

O’Neill

Edim

Obarein

(2014) Causes of prolonged waiting time in public health facilities among health care seekers in Calabar municipal council of cross river state, Nigeria. Research on Humanities and Social Sciences 4: 43–47.

51.

Onwujekwe

Etiaba

Oche

(2015) Patient satisfaction with health care services: A case study of the federal medical centre, Makurdi, north central Nigeria. International Journal of Medicine and Health Development 18(1): 8–16.

52.

Paul

K. I.

Moser

(2009) Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior 74: 264–282.

53.

Rauf

Blitz

J. J.

Geyser

M. M.

Rauf

A. A.

(2009) Quality improvement cycles that reduced waiting times at Tshwane District hospital emergency department. South African Family Practice 50: 43–43.

54.

Shirley

E. D.

Sanders

J. O.

(2013) Patient satisfaction: Implications and predictors of success. The Journal of Bone & Joint Surgery 95: e69.

55.

Sinclair

(2007) Emergency department overcrowding—Implications for paediatric emergency medicine. Paediatrics & Child Health 12: 491–494.

56.

Taylor

Kennedy

M. P.

Virtue

Mcdonald

(2006) A multifaceted intervention improves patient satisfaction and perceptions of emergency department care. International Journal for Quality in Health Care 18: 238–245.

57.

Thatcher

(2005) Outpatient waiting time in Jos University Teaching Hospital (JUTH). Highland Medical Research Journal 3: 36–42.

58.

Thompson

D. A.

Yarnold

P. R.

Williams

D. R.

Adams

S. L.

(1996) Effects of actual waiting time, perceived waiting time, information delivery, and expressive quality on patient satisfaction in the emergency department. Annals of Emergency Medicine 28: 657–665.

59.

Tiwari

Goel

Singh

(2014) Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India. Journal of Emergencies, Trauma, and Shock 7: 160–165.

60.

Urden

L. D.

(2002) Patient satisfaction measurement: Current issues and implications. Professional Case Management 7: 194–200.

61.

Vadhana, M. (2012). Assessment of patient satisfaction in an outpatient department of an autonomous hospital in Phnom Penh, Cambodia (Doctoral dissertation). Ritsumeikan Asia Pacific University, Beppu, Japan.

62.

Welch

Bailey

N. J.

(1952) Appointment systems in hospital outpatient departments. The Lancet 259: 1105–1108.

63.

Yeboah

Thomas

(2014) A cost effective way of reducing outpatient clinic waiting times: How we did it. The Internet Journal of Healthcare Administration 7: 5.

64.

Zhang, X.-L., Zhu, T., Luo, L., He, C.-Z., Liu, Z., & Shen, W.-W. (2014). Patient flows in the? outpatient-emergency+ inpatient??? mode: A conceptual model and data analysis. In 2014 11th International Conference on Service Systems and Service Management (ICSSSM), 25–27 June 2014 (pp. 1–5). New York, NY: IEEE.