Exploring the Impact of Waiting Times on Patient Satisfaction across the Outpatient Journey of Dermatology Department Visitors

Introduction

Patient satisfaction is a critical measure of healthcare quality and is influenced by several factors, including effective communication and follow-up care. Although many healthcare providers express an interest in patient satisfaction surveys, the results are often underutilized by hospital staff and rarely discussed in team settings, leading to missed opportunities for improvement.¹ Service efficiency plays a central role in patient satisfaction, with waiting time (WT) being  a particularly influential factor. Patients' satisfaction is highly affected by the time spent waiting for medical services, as variability in WTs can result in reduced patient satisfaction and can be influenced by clinical and non-clinical factors that could be mitigated with standardized hospital operations.²

Prolonged waiting times have a well-documented negative impact on patient satisfaction, diminishing patients’ confidence in their care providers and reducing their perception of care quality.³ Extended waits in healthcare settings often lead to increased frustration, anxiety, and dissatisfaction among patients, highlighting the importance of minimizing WT to enhance service quality.

This study examined the impact of actual WT on patient satisfaction, aiming to offer insights for healthcare providers to improve service delivery. Past research has shown that outpatient waiting times significantly influence patient satisfaction, particularly in resource constrained settings. Efficient outpatient management directly affects patients' perceptions of care, especially in developing countries where waiting periods are often prolonged due to limited resources.⁴ For instance, in a tertiary care hospital in Saudi Arabia, shorter WTs were associated with higher patient satisfaction scores, supporting the idea that reducing WTs can positively impact patient experiences.⁵ A study in Gujarat, India emphasized that reducing waiting times is a critical factor in enhancing outpatient satisfaction in healthcare settings.⁶

Objectives

1. To determine the average WT of patients in dermatology OPD of the hospital.

2. To determine patient satisfaction in dermatology OPD of the hospital.

3. To study the effect of WT on patient satisfaction in dermatology OPD.

Materials and Methods

The study surveyed 120 patients aged 18 to 60 years who were seeking laser services at the Dermatology Outpatient Department (OPD) of a tertiary care teac- hing hospital.

The sample size was calculated based on a prior study by Rajbanshi et al., which reported that 91.5% of patients had a high level of satisfaction. Using this proportion (P = 0.915) and considering a 5% level of significance (Z1-α/2 = 1.96) and a 5% margin of error (E = 0.05), the sample size was estimated using the formula:

Data collection took place over a one-month period, starting from July 13, 2022, during weekdays between 10 am and 3 pm. Waiting time (WT) data was directly observed and recorded for each patient at different service stages. Patient satisfaction was assessed using a structured questionnaire, which included questions rated on a five-point Likert scale to quantify satisfaction levels at every stage of the outpatient journey and the total for each service stage was calculated.

Prior to data entry, all variables were systematically coded for ease of analysis. The statistical analysis involved descriptive statistics to summarize patient demographics, waiting times, and satisfaction levels. Additionally, Pearson correlation was used to examine the relationship between waiting times at each service stage (e.g., registration, consultation, billing, and pharmacy) and corresponding patient satisfaction. This analysis aimed to identify patterns and assess the strength and direction of associations between waiting times and satisfaction across the outpatient journey.

The statistical analysis involved descriptive statistics and pearson correlation to examine the relationship between waiting times and patient satisfaction across various stages of the outpatient journey. Previous studies have employed similar methodologies to examine patient preferences and satisfaction based on waiting times in outpatient settings.⁷

Results

The findings of this study revealed important insights into the relationship between WT and patient satisfaction.

Patient satisfaction with service time and WT at different areas of the OPD journey

The findings on patient satisfaction with respect to waiting and service time across different areas of the outpatient journey revealed varying levels of dissatisfaction. Registration WT had a high dissatisfaction rate of 42%, with 48% neutral and only 10% satisfied, though the registration process itself showed better satisfaction at 28%. In the Derma OPD, 25% of patients were dissatisfied with WTs, and satisfaction was moderate at 21%, while satisfaction with consultation and disease explanation was notably higher at 34% and 47%, respectively. Procedure WT reflected a similar dissatisfaction as registration (42%), with only 10% satisfied. Additionally, billing WT had the highest dissatisfaction at 67%, with minimal satisfaction at 11%. Pharmacy WT, on the other hand, had a relatively better satisfaction rate of 40% (Table 1). Overall, while WTs in key areas like billing and procedures were associated with high dissatis- faction, service-related aspects such as pharmacy service and disease explanation exhibited higher satisfaction rates, reflecting the variability in patient experience across different stages of the outpatient journey.

The study results showed a significant relationship between WTs and patient satisfaction in a Dermatology outpatient department (OPD). The mean WT for registration was 18 minutes, leading to noticeable dissa- tisfaction among participants. Conversely, satisfaction regarding information and guidance was relatively high, with many expressing neutral to positive feelings. At the OPD, the average WT was 41 minutes, accompanied by a 14-minute consultation time, with many participants rating their satisfaction in these aspects as ‘neutral’ or ‘positive’. Billing services took an average of 10 minutes and yielded mixed satisfaction levels. Dermatology procedures had a 36-minute mean duration, showing varied satisfaction among a smaller percentage of patients, while pharmacy services, averaging 22 minutes, generally received favorable feedback, particularly regarding pharmacist interac- tions. Overall, most patients rated their experience as ‘very good’ or ‘excellent’, despite some dissatisfaction with specific waiting periods (Figure 1).

The analysis of specific areas revealed that longer registration WTs correlate with decreased patient satisfaction due to frustration. Although the correlation between OPD WTs and satisfaction was weak, longer waits still appear to negatively affect experiences. In contrast, longer consultation times typically enhance satisfaction, as patients feel more valued when doctors thoroughly address their concerns. Extended billing times can slightly reduce satisfaction due to perceptions of inefficiency, while longer procedure WTs may increase anxiety among patients. Nevertheless, efficient procedures, even if time-consuming, can lead to higher satisfaction levels, as they are perceived as indicators of quality care. Additionally, shorter pharmacy WTs contribute to better satisfaction, allowing patients to promptly access medications. The overall negative correlation between time spent in various service areas and patient satisfaction underscores the importance of minimizing WTs to enhance the overall patient experience (Figure 2).

Discussion

This study examined the relationship between WTs at various stages of a hospital visit and patient satisfa- ction. The average registration wait time of 18 minutes was associated with noticeable dissatisfaction, while the longer average wait time of 41 minutes for consultation was generally more acceptable to patients. Notably, longer consultation times positively correlated with patient satisfaction, reinforcing the findings of Bluestein et al., which indicate that extended interaction with healthcare providers enhances the overall patient experience.³

Moreover, the study by Rajbanshi et al. reported that patient satisfaction may increase with better medication availability and shorter wait times, rein- forcing the significance of efficient service delivery in enhancing patient experiences. Similarly, research from a rural hospital in West Bengal echoed these f indings, illustrating that patients often express greater dissatisfaction with WTs, particularly in outpatient departments.⁷

A cross-sectional study in Saudi Arabia further corroborates this trend, revealing that despite long WTs, patients' satisfaction can be higher in specific clinics like family medicine, suggesting that clinic type and quality of service significantly influence patient perceptions. Additionally, Mehra et al. (2016) found that prolonged WTs negatively impacted patient satisfaction, particularly among male patients.⁸

In pediatric settings, Sengupta et al. (2019) emphasized the importance of addressing parents' perceptions and WTs to improve overall satisfaction. This highlights the need for effective communication and management strategies in healthcare settings to optimize the patient experience.⁹

A study conducted by Umar et al. in a tertiary health institution in Northern Nigeria identified prolonged waiting times as a critical factor negatively impacting patient satisfaction. Bottlenecks were particularly pronounced in registration and consultation stages, emphasizing the need to address these areas to enhance service delivery.¹⁰ These findings align with the results of this study, which demonstrated a significant correlation between registration waiting times and patient dissatisfaction.

Consumer satisfaction in outpatient departments is influenced not only by waiting times but also by the quality of interaction with healthcare providers and the perceived efficiency of hospital services. A study conducted by Prasanna et al., emphasized that improving provider-patient interactions through better communication and respect significantly enhances patient satisfaction.¹¹ This is consistent with the present findings, which highlighted the positive association between longer consultation times and increased patient satisfaction, attributed to extended provider patient interaction.

The implementation of queuing network analysis to optimize outpatient department workflows demonstrated marked improvements in patient flow and satisfaction. In a research by Makwana et al., this methodology helped identify and mitigate delays in service delivery, providing a structured approach to managing patient f low.¹² Such techniques are particularly relevant for addressing registration and consultation delays noted in this study and can serve as actionable recommendations for improving outpatient department operations.

A content analysis study of patient satisfaction by Anderson et al. revealed that clear communication about expected wait times, coupled with respectful and efficient service delivery, are pivotal in shaping positive patient experiences. The study stressed that patients are more likely to accept waiting times if they are informed and treated with dignity during their visit.¹³ These findings support the current study’s recommendation to implement communication protocols for setting realistic patient expectations regarding waiting times.

Limitations of the study

The study was carried out in a small subset in OPD and therefore the generalizability of the findings has limited scope. The constraint suggests the need for future research to validate the findings in different clinical departments and healthcare facilities with larger and more varied sample sizes. Expanding the scope of future studies to include multi-department or multi-institutional analyses could provide a more comprehensive under- standing of the relationship between waiting times and patient satisfaction across healthcare systems.

Conclusion

Specific insights in this study reveal that positive aspects of the patient experience are linked to direct interactions with healthcare providers, such as consultation and pharmacy services, while negative aspects are associated with administrative WTs like registration and billing.  The study emphasizes the need for healthcare providers to streamline processes and optimize WTs, focusing on efficient service delivery and effective communication to enhance patient satisfaction.

To enhance patient satisfaction in the Dermatology OPD, key strategies include streamlining registration and billing through technologies like patient IDs and real time data capture, decentralizing administrative tasks to reduce congestion, and improving communication with real-time updates on wait times. Optimizing workflows by staggering appointments and adding staff during peak hours can further reduce delays. Ensuring meaningful patient engagement during consultations and streamlining pharmacy operations for faster service are also crucial to creating a more patient-centered care environment. These strategies can be extended to other hospital departments for enhanced systemic efficiency and patient centered care.

Conflict of Interest

None