ABSTRACT
Background: There is lack of information regarding patient-doctor ratio in government hospitals in India. The aim of the present study was to measure patient-doctor ratio across nine super specialty clinics. The objectives were to measure Outpatient department (OPD) patient-faculty and patient-senior resident doctor ratio, to measure number of patients seen per unit time and time spent per patient in OPDs across nine super specialty clinics.Methods: Total number of OPD patient visits in year 2018 was retrieved for cardiology, gastroenterology, gastrointestinal surgery, neurology, neurosurgery, nephrology, urology, paediatric surgery and oncology. Number of faculties and senior residents working in above specialties were obtained. Ratio of OPD patients to faculties and senior residents across nine above clinics were derived and compared. The average time spend per patient in OPDs across nine above clinics was calculated by number of working days in year 2018 and number of working hours or day in OPD clinics, excluding public holidays.Results: Total 3,59,099 OPD patient visits were registered in year 2018 across nine super specialty clinics. Patient to faculty ratio was highest for gastroenterology followed by neurology and cardiology, while least for neurosurgery and paediatric surgery in descending order. Gastroenterology, neurology and oncology OPDs saw more than 200 patients per working day; with average time spend per patient consultation was two minutes. Compared to super specialty physicians who spend average of 2.2 minutes per patient consult, surgical disciplines used an average of ten minutes per patient for consultation.Conclusions:Super specialty clinics in government hospitals are over worked and under staffed with heavy patient load. Multiple parallel clinics in concerned specialty will provide more time and quality of services per patient.
ABSTRACT
Introduction@#The efficacy of opioids for cancer pain has been proven. However, opioids specifically Morphine usage for cancer pain relief among resident physicians is still low. One of the major contributing factors to inadequate pain control is the healthcare provider’s lack of knowledge about cancer and non- cancer pain. Hence, this study was done to assess and identify the level of knowledge and practice of the physicians on opioid use for chronic pain.@*Methods@#A validated questionnaire on knowledge and practice was given to the resident physicians in training in 2 government hospitals in region 1 namely Ilocos Training and Regional Medical Center (ITRMC) and Mariano Marcos Memorial Hospital and Medical Center (MMMH&MC). Descriptive statistics were used to analyze demographics, overall knowledge and practice on morphine use among resident physicians and inferential statistics were used to test for comparative study between the two different institutions.@*Results@#A total of 83 respondents, 50 from ITRMC and 33 from MMMH&MC, 56 of which were females and 27 were males showed that the overall knowledge of resident physicians elucidates that out of 11 questions asked, they acquired half normative or mean scores of 6.44 in ITRMC and 5.61 in MMMH&MC, respectively. Resident physicians in both government hospitals do not use or give morphine use acquiring more than half, 27 out of 50 or 54.0% in ITRMC and 23 out of 29 or 79.3% in MMMH&MC.@*Conclusion@#The results showed that the level of understanding and knowledge on morphine use among resident physicians from both government hospitals is inadequate. Thus, their limited knowledge hinders the utilization of morphine use.