Time reduction of new patient consultation at the Department of Ophthalmology and Visual Sciences of a Philippine Tertiary Hospital

Objective@#To decrease the total time spent of new patients on a General Clinic consult at the Department of Ophthalmology and Visual Sciences of a Philippine Tertiary Hospital. @*Methods@#A time quality management team was formed. The description of the process of a General Clinic new patient consult was elucidated and was consolidated in a data collection form. Convenience sampling of the population was done. The collection and analysis of the data were done with institution of interventions to address the factors causing the prolonged consultation visit; then, pre-intervention analysis, post-intervention analysis and comparison were done. @*Results@#Thirty-five new patients were tracked prior to and after intervention. Among the identified causes for prolonged new patient consult were delay in temporary chart, front of chart and blue card issuance, insufficient examination tools and resident dedicated to the General Clinic, unnecessary examination and patient not being around when called. Most causes were addressed. A mean decrease of 68±112 minutes or approximately 18% in total time stay was noted. @*Conclusion@#This study showed that the total consultation time of a new patient in General Clinic decreased. This was achieved with the help of most of the personnel involved in the system after identifying factors causing the prolonged consultation visit and instituting interventions to address these identified factors. The improvement in health service delivery was taken as a step by step process. A preliminary step was demonstrated in this paper for future interventions for better service delivery.

Analysis of New Patient's Willingness to Pay Additional Costs for Securing Satisfactory Consultation Time / 보건행정학회지

BACKGROUND: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. METHODS: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (≤3 minutes, 3–5 minutes, 5–10 minutes, and >10 minutes), and SCT into 3 groups (≤5 minutes, 5–10 minutes, and >10 minutes). On the basis of WPAC, we estimated new patient's SCT. RESULTS: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5–10 minutes was higher than that RCT ≤3 minutes (odds ratio=1.78). Payable amount was highest in RCT >10 minutes (6,950 Korea won) and SCT >10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). CONCLUSION: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

Trends of the New Outpatients in a University-based Family Practice / 가정의학회지

BACKGROUND: Analysis of outpatient visits to primary care offers essential data for residency training by understanding 'reasons for encounter (RFE).' This study was designed to recognize the effect of population aging on demographic characteristics and RFEs. METHODS: We included all patients who had visited family practice clinic in Kyung Hee University Hospital in Seoul during each first 5 working days of September, October, and November in 2001 and 2008. New patients included those who hadn't visited within the last 6 months or more. Information on each patient's age, sex, and reason for encounter was obtained from the electronic medical record. The RFEs were compared using International Classification of Primary Care (ICPC)-2-E. RESULTS: Mean age of overall outpatients was 50.5 and 52.4 years in 2001 and 2008 respectively. The number of new outpatient visits increased from 215 (21.3%) to 326 (29.7%) between 2001 and 2008 (P < 0.001) along with the number of patients aged 65 or more from 7.4% to 12.0% (P = 0.08). Mean age of established patients was 52.5 and 56.9 years (P < 0.001), and the patients aged 65 or more was 14.1% and 35.8% (P < 0.001) in 2001 and 2008 respectively. Analysis by ICPC-2-E revealed a decrease in chapter A in 2008 (P = 0.03) and an increase in chapter F, L, and X (P = 0.01, 0.003, <0.001). Component 1 had increased (P = 0.01), and component 2 had decreased (P = 0.04) in proportion. CONCLUSION: Changes in population composition have brought a shift of the distribution of age in outpatients, more significantly in follow-up patients. Comparison by ICPC-2-E showed changes in RFEs of new patients between 2001 and 2008.