Association between waiting time, service time and patient satisfaction in the out-patient department of a tertiary care hospital in Maharashtra

Background: Quality patient care is controlled by various factors - degree of fulfilment of patients' needs being one of them. Lesser waiting times, empathetic doctors and availability of medications yield more satisfied patients. Methods: A descriptive cross-sectional study was carried out among 80 patients attending the OPD of a tertiary care hospital from 9 am to 1 pm, Monday to Saturday from 8th February 2021 to 8th April 2021. Consenting patients were shadowed and observed until they completed their visit. Actual waiting time, consultation time and overall visit duration were calculated. An exit interview was conducted to assess satisfaction with waiting time, infrastructure and doctor-patient interaction. Results: The mean waiting time in one visit was 59.025±39.497 minutes. The mean consultation time with the doctor was 6.925±7.688 minutes. Statistical analysis showed that patients with lesser waiting time were significantly more satisfied with hospital services (p=0.004). Domains of dissatisfaction were waiting time at the registration desk, outside the OPD, seating arrangement, cleanliness and availability of medications. Doctor-patient interaction and consultation time were rated highly. Conclusions: The results showed that significant changes are required in the queueing system and hospital infrastructure. The positive response received in case of doctor-patient interaction is a step in the right direction. Regular surveys can help us rectify oversights in the present healthcare system.

Use of and satisfaction with complementary and alternative medicine in four chronic diseases: A cross-sectional study from India.

Background. We assessed the extent of use of complementary and alternative medicine (CAM) by patients with four chronic diseases—epilepsy, HIV, rheumatoid arthritis (RA) and diabetes mellitus (DM)—at a tertiary care, teaching hospital of allopathic medicine in India. We also assessed patients’ satisfaction with CAM. Methods. Adults attending the outpatient clinics for epilepsy, HIV, RA and DM who took CAM were recruited over a period of 16 weeks. After obtaining written informed consent, they were administered the ‘Treatment Satisfaction Questionnaire for Medication’ (TSQM)TM to assess satisfaction in domains such as effectiveness, no side-effect, convenience and global satisfaction. Results. Of the 4664 patients screened, 1619 (34.7%) were using CAM and 650 (40%) of them consented to participate. The extent of use of CAM was 63% in patients with DM, 42.7% in RA, 26.2% in HIV and 7.7% in epilepsy. Ayurveda 57.1% (95% CI 53.27–60.89) was the most frequently used CAM. Satisfaction in terms of effectiveness and global satisfaction was highest among patients with HIV (69.4% and 69.2%, respectively) and least among those who had RA (56.6% and 54.1%, respectively). High scores were reported to ‘no side-effect’ domain in all the four diseases. The proportion of physicians who were aware about their patients’ using CAM was 100% in patients with RA, 95% in HIV, 74% in epilepsy and 29% in DM. Conclusion. A large proportion of patients with four chronic diseases reporting to a hospital of allopathic medicine in India were also using CAM and were satisfied with its use. Given the potential interaction of CAM with allopathic medicines, a history of use of CAM should be elicited in clinical practice.

Acute respiratory infection in children: a survey in the rural community.

The prevalence of Acute Respiratory Infections was 7.6% in a total of 10,951 children below 5 yrs surveyed. The annual incidence was estimated to be 2.6 episodes per child. The prevalence was highest in the 6 months--2 yrs of age. Majority of the episodes were mild in nature (86.2%), while only 1.7% episodes were severe in nature. A substantial number of episodes (27.3%) did not receive any treatment. There was no association between the severity of ARI episodes and the treatment received. Registered medical practitioners were the main source of treatment. Far distance of the hospital was the reason for not receiving any treatment among untreated cases. The outcome was better in those episodes treated by a qualified MBBS doctor, as compared to other sources of treatment.