Determinants of hospital waiting time for outpatient care in India: how demographic characteristics, hospital ownership, and ambulance arrival affect waiting tim

Abstract

Background: Waiting time in hospital outpatient clinics affects patient satisfaction, access to care, health outcomes, trust, willingness to return and hospital revenue. Only a few studies have explored length and variability of waiting times among patients. This study is an attempt to understand factors affecting waiting time experienced by patients in outpatient clinics.Methods: For this study, data were collected in 2012 from 830 patients seeking care from outpatient clinics located in 30 randomly selected hospitals in the district of Nellore, India. Linear regression and logistic regression models have been used to identify the effect of various determinants on hospital waiting times.Results: The average waiting time in government hospitals was 20.3 minutes compared to 15.5 minutes in private hospitals and 39.71 minutes in voluntary hospitals. Waiting time of men was about six minutes lower than women. After controlling for other patient related and hospital related factors, median wait time was 19% lower for male patients compared to females. Length of waiting declines with patient's age. Patients arriving by ambulance waited 64% less that patients not arriving by ambulance but this pattern was not valid for public hospitals.Conclusions: Significant gender bias was present in all facility-types implying that policy and legal interventions would be required. For-profit hospitals had lower waiting time of patients to ensure higher demand for their services by the economically better-off sections of the population. The results highlight the importance of lowering the waiting time in public sector hospitals, especially for patients arriving in ambulances.