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Wait and consult times for primary healthcare services in central Mozambique: a time-motion study

BACKGROUND: We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times. DESIGN: We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces betwee...

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Autores principales: Wagenaar, Bradley H., Gimbel, Sarah, Hoek, Roxanne, Pfeiffer, James, Michel, Cathy, Cuembelo, Fatima, Quembo, Titos, Afonso, Pires, Gloyd, Stephen, Lambdin, Barrot H., Micek, Mark A., Porthé, Victoria, Sherr, Kenneth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007246/
https://www.ncbi.nlm.nih.gov/pubmed/27580822
http://dx.doi.org/10.3402/gha.v9.31980
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author Wagenaar, Bradley H.
Gimbel, Sarah
Hoek, Roxanne
Pfeiffer, James
Michel, Cathy
Cuembelo, Fatima
Quembo, Titos
Afonso, Pires
Gloyd, Stephen
Lambdin, Barrot H.
Micek, Mark A.
Porthé, Victoria
Sherr, Kenneth
author_facet Wagenaar, Bradley H.
Gimbel, Sarah
Hoek, Roxanne
Pfeiffer, James
Michel, Cathy
Cuembelo, Fatima
Quembo, Titos
Afonso, Pires
Gloyd, Stephen
Lambdin, Barrot H.
Micek, Mark A.
Porthé, Victoria
Sherr, Kenneth
author_sort Wagenaar, Bradley H.
collection PubMed
description BACKGROUND: We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times. DESIGN: We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces between January and April 2011. Negative binomial generalized estimating equations were used to model associated health facility factors. RESULTS: Mean wait times (in minutes) were: 26.1 for reception; 43.5 for outpatient consults; 58.8 for antenatal visits; 16.2 for well-child visits; 8.0 for pharmacy; and 15.6 for laboratory. Mean consultation times (in minutes) were: 5.3 for outpatient consults; 9.4 for antenatal visits; and 2.3 for well-child visits. Over 70% (884/1,248) of patients arrived at the clinic to begin queuing for general reception prior to 10:30 am. Facilities with more institutional births had significantly longer wait times for general reception, antenatal visits, and well-child visits. Clinics in rural areas had especially shorter wait times for well-child visits. Outpatient consultations were significantly longer at the smallest health facilities, followed by rural hospitals, tertiary/quaternary facilities, compared with Type 1 rural health centers. DISCUSSION: The average outpatient consult in Central Mozambique lasts 5 min, following over 40 min of waiting, not including time to register at most clinics. Wait times for first antenatal visits are even longer at almost 1 h. Urgent investments in public-sector human resources for health alongside innovative operational research are needed to increase consult times, decrease wait times, and improve health system responsiveness.
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spelling pubmed-50072462016-09-07 Wait and consult times for primary healthcare services in central Mozambique: a time-motion study Wagenaar, Bradley H. Gimbel, Sarah Hoek, Roxanne Pfeiffer, James Michel, Cathy Cuembelo, Fatima Quembo, Titos Afonso, Pires Gloyd, Stephen Lambdin, Barrot H. Micek, Mark A. Porthé, Victoria Sherr, Kenneth Glob Health Action Original Article BACKGROUND: We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times. DESIGN: We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces between January and April 2011. Negative binomial generalized estimating equations were used to model associated health facility factors. RESULTS: Mean wait times (in minutes) were: 26.1 for reception; 43.5 for outpatient consults; 58.8 for antenatal visits; 16.2 for well-child visits; 8.0 for pharmacy; and 15.6 for laboratory. Mean consultation times (in minutes) were: 5.3 for outpatient consults; 9.4 for antenatal visits; and 2.3 for well-child visits. Over 70% (884/1,248) of patients arrived at the clinic to begin queuing for general reception prior to 10:30 am. Facilities with more institutional births had significantly longer wait times for general reception, antenatal visits, and well-child visits. Clinics in rural areas had especially shorter wait times for well-child visits. Outpatient consultations were significantly longer at the smallest health facilities, followed by rural hospitals, tertiary/quaternary facilities, compared with Type 1 rural health centers. DISCUSSION: The average outpatient consult in Central Mozambique lasts 5 min, following over 40 min of waiting, not including time to register at most clinics. Wait times for first antenatal visits are even longer at almost 1 h. Urgent investments in public-sector human resources for health alongside innovative operational research are needed to increase consult times, decrease wait times, and improve health system responsiveness. Co-Action Publishing 2016-08-30 /pmc/articles/PMC5007246/ /pubmed/27580822 http://dx.doi.org/10.3402/gha.v9.31980 Text en © 2016 Bradley H. Wagenaar et al. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.
spellingShingle Original Article
Wagenaar, Bradley H.
Gimbel, Sarah
Hoek, Roxanne
Pfeiffer, James
Michel, Cathy
Cuembelo, Fatima
Quembo, Titos
Afonso, Pires
Gloyd, Stephen
Lambdin, Barrot H.
Micek, Mark A.
Porthé, Victoria
Sherr, Kenneth
Wait and consult times for primary healthcare services in central Mozambique: a time-motion study
title Wait and consult times for primary healthcare services in central Mozambique: a time-motion study
title_full Wait and consult times for primary healthcare services in central Mozambique: a time-motion study
title_fullStr Wait and consult times for primary healthcare services in central Mozambique: a time-motion study
title_full_unstemmed Wait and consult times for primary healthcare services in central Mozambique: a time-motion study
title_short Wait and consult times for primary healthcare services in central Mozambique: a time-motion study
title_sort wait and consult times for primary healthcare services in central mozambique: a time-motion study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007246/
https://www.ncbi.nlm.nih.gov/pubmed/27580822
http://dx.doi.org/10.3402/gha.v9.31980
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