A Proposal on the Impact of Immunization in Health Care Services; Case Study Asari-Toru Local Government Area
Chapter One
Objective of the study
The following research objectives will be determined to guide the study;
- To find the knowledge of health professional on patients waiting and consultation time in federal medical centers, Yenagoa
- To find out the perception of health professional on patients waiting and consultation time in federal medical center, Yenagoa
- To find out the factors that causes patient time waiting and consultation time in federal medica center, Yenagoa
Chapter Two
Review of related literature
Waiting times
The term ‘waiting time’ in health care studies is used in two distinct ways. The first meaning is the “waiting time before the first routine appointment”, usually measured in weeks or months. The second meaning is the “waiting time in the clinic” which is usually measured in minutes. Other definitions have also been discussed in the literature. For example, Mike Hart (the author of Survey Design and Analysis Using TURBOSTATS, and Principal Lecturer in the Department of Public Policy and Managerial Studies in the Leicester Business School, De Montfort University, Leicester, UK.) cites the National Audit Office (NAO) study which used “three different methods to calculate an average waiting time: (1) time between appointment time and the start of the consultation; (2) time between arrival time and the start of the consultation; and (3) waiting time estimated periodically throughout the clinic”.2 Another measure of waiting time used internationally – the “Total Primary Waiting Time” – is the total length of time a patient waits before receiving medical care. This measure computes the total patient waiting time spent at the facility, excluding the total service time. If time was spent waiting for anything other than a health-specific? service, then this time should also be subtracted from the total time spent in the facility.
Measuring waiting times
There is a diversity of performance benchmarks to consider in the measurement of patient waiting times. Cost, time, congestion, and fairness were considered when waiting time was measured in a review of outpatient scheduling by Cayirli T, Veral E (2003). This review found that most studies used combinations of patients’ waiting time, doctors’ idle time, practitioner overtime and patient flow time to calculate mean total cost. In general, most waiting time studies calculate the mean, maximum, frequency, distribution of patients’ waiting time as well as the mean, variance, and frequency distribution of doctor’s idle time. Studies focussing on “fairness” typically measured the mean waiting time of patients according to their place in the queue in the clinic. One such study, conducted in hospital outpatient departments in England, focused on queues and appointment systems amongst others and concluded that waiting-times were sensitive to small changes in the appointment intervals. Hart cautioned against the ‘Hawthorne effect’ where waiting times seemed to decrease when doctors knew that their clinic was being monitored. This indicates that the observation process could influence the activities monitored
Quality of Care and its relationship with waiting time
Quality of care depends on many factors including practitioners’ expertise, availability of medical equipment and patients’ experience. However, it is mainly defined by patients’ perception. If waiting time is too long, patients develop a negative perception of their experience and relate it as poor quality of care. Many patient satisfaction surveys conducted in public health care facilities show that even where patients may be satisfied with general services and clinical services, there is general dissatisfaction with waiting time for services which is often compounded by an absence of an explanation. Patient satisfaction surveys from Wales and Nigeria show that long waiting times were a major reason for patients’ dissatisfaction in outpatient services. In addition, a South African study, conducted to determine the levels of patient satisfaction with services at primary care antiretroviral treatment (ART) assessment, sites showed that despite the high quality of technical service delivered and patient satisfaction with general services, long waiting times for services resulted in dissatisfaction by patients. An American national online (DrScore.com) survey of patient’s satisfaction showed that although longer waiting times were associated with lower patient satisfaction (p < 0.05), time spent with the physician was the strongest predictor of patient satisfaction. The results of the study shows that decreased satisfaction associated with long waiting times is substantially reduced with increased time spent with the physician (5 minutes or more). Importantly, the combination of long waiting time to see the doctor and having a short doctor visit is associated with very low overall patient satisfaction. The authors conclude that it would be counterproductive to shorten patient waiting times at the expense of time spent with the patient in order to improve patient satisfaction scores.
Chapter Three
RESEARCH DESIGN AND METHODOLOGY
The researcher used descriptive research survey design in building up this project work. The choice of this research design was considered appropriate because of its advantages of identifying attributes of a large population from a group of individuals. The design was suitable for the study as the study sought to knowledge and perceptions of health professionals on patients waiting and consultation time in federal medical centers
Chapter Four
METHOD OF DATA ANALYSIS
The researcher will employ oral and direct interview in administering this research questions. Responses from the respondents were needed unlike questionnaires, which is less rewarding due to late receipt and loss of responses from respondents. The collected data will be cleaned, coded and entered into Statistical Package for Social Sciences (SPSS) version 21 for windows software for analysis. A descriptive presentation of the data will be given. The variables age and sex will be also included as covariates.
References
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