III. Profile, expectation and satisfaction of outpatients (1970-1972).

The present study deals with patients' assessment of the OPD and the experimental changes in terms of "patient satisfaction". The hypothesis tested, stated that the level of satisfaction of clients of the OPD at Machakos hospital would increase after the introduction of changes in the operational and technical procedures. Data on clients' profiles and satisfaction were collected by means of structured interview schedule; 24 background variables and 17 satisfaction indicators were selected for final analysis to compare profiles and satisfaction of 324 baseline and 367 evaluation respondents. Profiles and satisfaction differed significantly at the 5% level. The significant difference in satisfaction could not be explained by the difference in profiles; the hypothesis was confirmed. A detailed analysis showed that total clinic time (the total time patients spent in the clinic) was significantly correlated with some of the 24 background variables and with some of the 17 satisfaction indicators; its duration was one of the key determinants for patient satisfaction, with a highly discriminative value. Another key variable was the answer to the question: "Did you get the treatment you wanted?". OPD patients discriminated various aspects and facets of OPD process and procedures for their assessment.

IV. Health services research; the case of the outpatient department.

The main findings of the series of operational and satisfaction studies in the outpatient department of Machakos Hospital (1968-1972) were presented as a case study of evaluation research. The relevant theoretical aspects of evaluation research in the ambulatory care setting are reviewed. In an attempt to feed back the implications of the above studies for planning and management of services, for training of staff and for future research are presented.