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Innovative Care Model for Non Communicable Disease Patients on Patient Waiting Times in Peripheral Health Clinic in Base Hospital, Elpitiya

Received: 28 January 2018     Accepted: 2 August 2018     Published: 31 August 2018
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Abstract

Long queue and long waiting time for taking appointment, consulting a doctor and to get drugs is a critical problem to patients with Non-communicable diseases who are following in government health sector. Many primary healthcare services in Sri Lanka is delivered through vertical systems, where services for routine issuing appointment, consultation and issuing drugs are co-located but use separate physical space, staff and medical records. Aim of the research leads to integration of the systems deteriorates the waiting time and reduces the worse health outcomes in the long run. A care model was developed integration of consultation and issuing drugs, with permanent issuing of routine appointment in rural healthcare settings, Elpitiya. Data on waiting time of patients during two seven-day periods before and six months after the integration were collected using a time and motion study. Statistical tests were conducted to investigate whether the two observation periods differed in operational details such as staffing, patient arrival rates, mix of patients etc. Previous level of attendance was analysed by their clinic records (before intervention). Multiple linear and logistic regression repeated measures analyses were used to assess the program's effects. Comparison of raw data showed that waiting times decreased by 7.2 hours to 3hours, after integration (p<0.01). Clinic patients attendance was remarkably improved with regular clinic service after implementing appoint system from 35%-60% to 85%-90%. The rate of clinic attendance was increased dramatically over the period from 6 months. Waiting time for attending clinic was declined and waiting in lines were avoided. Moreover, the intervention did improve clinic utilization and satisfaction. Integrating health services have the potential of reducing waiting times due to more efficient use of resources. Encouraging patients by new model is challenging and does appear to provide significant realistic benefits at rural, resource poor health settings beyond those provided by basic clinic services.

Published in European Journal of Clinical and Biomedical Sciences (Volume 4, Issue 3)
DOI 10.11648/j.ejcbs.20180403.12
Page(s) 46-50
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Patients Waiting Time, Care Model, Non Communicable Disease, Rural Health Care

References
[1] 2008-2013 Action plan for the global strategy for the prevention and control of non communicable diseases. World Health Organization – 2011
[2] Almomani, I. and A. AlSarheed (2016). "Enhancing outpatient clinics management software by reducing patients' waiting time." J Infect Public Health 9 (6): 734-743.
[3] Aeenparast, A., et al. (2015). "Waiting time for first outpatient visit in specialty level: assessing the provider related factors." Arch Iran Med 18 (3): 185-188.
[4] Doherty T, Chopra M, Tomlinson M, Oliphant N, Nsibande D, et al. Moving from vertical to intgrated child health programmes: experiences from a multi-country assessment of the Child Health Days approach in Africa. Trop Med Int Health. 2010; 15:296–305.
[5] Lawn JE, Rohde J, Rifkin S, Were M, Paul VK, et al. Alma-Ata 30 years on: revolutionary, relevant, and time to revitalise. Lancet. 2008; 372:917–927.
[6] Topp SM, Chipukuma JM, Giganti M, Mwango LK, Chiko LM, et al. Strengthening health systems at facility-level: feasibility of integrating antiretroviral therapy into primary health care services in Lusaka, Zambia. PLoS One. 2010; 5:e11522.
[7] Wagner G, Ryan G, Taylor S. Formative evaluation of antiretroviral therapy scale-up efficiency in sub-Saharan Africa. Aids Patient Care and Stds. 2007; 21:871–887.
[8] olebunders R, Bukenya T, Pakker N, Smith O, Boeynaems V, et al. Assessment of the patient flow at the infectious diseases institute out-patient clinic, Kampala, Uganda. Aids Care-Psychological and Socio-Medical Aspects of Aids/Hiv. 2007; 19:149–151.
[9] Hardon AP, Akurut D, Comoro C, Ekezie C, Irunde HF, et al. Hunger, waiting time and transport costs: time to confront challenges to ART adherence in Africa. AIDS Care. 2007; 19:658–665.
[10] Ward, P. R., et al. (2017). "'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia." BMC Health Serv Res 17 (1): 333.
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    Lasantha Krishan Hirimuthugoda, Hewa Kasakara Diwela Wannakuge Miyasiya Gajanayaka, Vithanage Narada Channa, Induwarie Harsha Gajanayaka Hewa Kasakara Diwala Wannakuge, Vithanage Milinda Chanaka Perera, et al. (2018). Innovative Care Model for Non Communicable Disease Patients on Patient Waiting Times in Peripheral Health Clinic in Base Hospital, Elpitiya. European Journal of Clinical and Biomedical Sciences, 4(3), 46-50. https://doi.org/10.11648/j.ejcbs.20180403.12

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    ACS Style

    Lasantha Krishan Hirimuthugoda; Hewa Kasakara Diwela Wannakuge Miyasiya Gajanayaka; Vithanage Narada Channa; Induwarie Harsha Gajanayaka Hewa Kasakara Diwala Wannakuge; Vithanage Milinda Chanaka Perera, et al. Innovative Care Model for Non Communicable Disease Patients on Patient Waiting Times in Peripheral Health Clinic in Base Hospital, Elpitiya. Eur. J. Clin. Biomed. Sci. 2018, 4(3), 46-50. doi: 10.11648/j.ejcbs.20180403.12

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    AMA Style

    Lasantha Krishan Hirimuthugoda, Hewa Kasakara Diwela Wannakuge Miyasiya Gajanayaka, Vithanage Narada Channa, Induwarie Harsha Gajanayaka Hewa Kasakara Diwala Wannakuge, Vithanage Milinda Chanaka Perera, et al. Innovative Care Model for Non Communicable Disease Patients on Patient Waiting Times in Peripheral Health Clinic in Base Hospital, Elpitiya. Eur J Clin Biomed Sci. 2018;4(3):46-50. doi: 10.11648/j.ejcbs.20180403.12

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  • @article{10.11648/j.ejcbs.20180403.12,
      author = {Lasantha Krishan Hirimuthugoda and Hewa Kasakara Diwela Wannakuge Miyasiya Gajanayaka and Vithanage Narada Channa and Induwarie Harsha Gajanayaka Hewa Kasakara Diwala Wannakuge and Vithanage Milinda Chanaka Perera and Suranga Paranagamage},
      title = {Innovative Care Model for Non Communicable Disease Patients on Patient Waiting Times in Peripheral Health Clinic in Base Hospital, Elpitiya},
      journal = {European Journal of Clinical and Biomedical Sciences},
      volume = {4},
      number = {3},
      pages = {46-50},
      doi = {10.11648/j.ejcbs.20180403.12},
      url = {https://doi.org/10.11648/j.ejcbs.20180403.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20180403.12},
      abstract = {Long queue and long waiting time for taking appointment, consulting a doctor and to get drugs is a critical problem to patients with Non-communicable diseases who are following in government health sector. Many primary healthcare services in Sri Lanka is delivered through vertical systems, where services for routine issuing appointment, consultation and issuing drugs are co-located but use separate physical space, staff and medical records. Aim of the research leads to integration of the systems deteriorates the waiting time and reduces the worse health outcomes in the long run. A care model was developed integration of consultation and issuing drugs, with permanent issuing of routine appointment in rural healthcare settings, Elpitiya. Data on waiting time of patients during two seven-day periods before and six months after the integration were collected using a time and motion study. Statistical tests were conducted to investigate whether the two observation periods differed in operational details such as staffing, patient arrival rates, mix of patients etc. Previous level of attendance was analysed by their clinic records (before intervention). Multiple linear and logistic regression repeated measures analyses were used to assess the program's effects. Comparison of raw data showed that waiting times decreased by 7.2 hours to 3hours, after integration (p<0.01). Clinic patients attendance was remarkably improved with regular clinic service after implementing appoint system from 35%-60% to 85%-90%. The rate of clinic attendance was increased dramatically over the period from 6 months. Waiting time for attending clinic was declined and waiting in lines were avoided. Moreover, the intervention did improve clinic utilization and satisfaction. Integrating health services have the potential of reducing waiting times due to more efficient use of resources. Encouraging patients by new model is challenging and does appear to provide significant realistic benefits at rural, resource poor health settings beyond those provided by basic clinic services.},
     year = {2018}
    }
    

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    T1  - Innovative Care Model for Non Communicable Disease Patients on Patient Waiting Times in Peripheral Health Clinic in Base Hospital, Elpitiya
    AU  - Lasantha Krishan Hirimuthugoda
    AU  - Hewa Kasakara Diwela Wannakuge Miyasiya Gajanayaka
    AU  - Vithanage Narada Channa
    AU  - Induwarie Harsha Gajanayaka Hewa Kasakara Diwala Wannakuge
    AU  - Vithanage Milinda Chanaka Perera
    AU  - Suranga Paranagamage
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    N1  - https://doi.org/10.11648/j.ejcbs.20180403.12
    DO  - 10.11648/j.ejcbs.20180403.12
    T2  - European Journal of Clinical and Biomedical Sciences
    JF  - European Journal of Clinical and Biomedical Sciences
    JO  - European Journal of Clinical and Biomedical Sciences
    SP  - 46
    EP  - 50
    PB  - Science Publishing Group
    SN  - 2575-5005
    UR  - https://doi.org/10.11648/j.ejcbs.20180403.12
    AB  - Long queue and long waiting time for taking appointment, consulting a doctor and to get drugs is a critical problem to patients with Non-communicable diseases who are following in government health sector. Many primary healthcare services in Sri Lanka is delivered through vertical systems, where services for routine issuing appointment, consultation and issuing drugs are co-located but use separate physical space, staff and medical records. Aim of the research leads to integration of the systems deteriorates the waiting time and reduces the worse health outcomes in the long run. A care model was developed integration of consultation and issuing drugs, with permanent issuing of routine appointment in rural healthcare settings, Elpitiya. Data on waiting time of patients during two seven-day periods before and six months after the integration were collected using a time and motion study. Statistical tests were conducted to investigate whether the two observation periods differed in operational details such as staffing, patient arrival rates, mix of patients etc. Previous level of attendance was analysed by their clinic records (before intervention). Multiple linear and logistic regression repeated measures analyses were used to assess the program's effects. Comparison of raw data showed that waiting times decreased by 7.2 hours to 3hours, after integration (p<0.01). Clinic patients attendance was remarkably improved with regular clinic service after implementing appoint system from 35%-60% to 85%-90%. The rate of clinic attendance was increased dramatically over the period from 6 months. Waiting time for attending clinic was declined and waiting in lines were avoided. Moreover, the intervention did improve clinic utilization and satisfaction. Integrating health services have the potential of reducing waiting times due to more efficient use of resources. Encouraging patients by new model is challenging and does appear to provide significant realistic benefits at rural, resource poor health settings beyond those provided by basic clinic services.
    VL  - 4
    IS  - 3
    ER  - 

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Author Information
  • Department of Community Medicine, Post Graduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka

  • Department of Non-communicable Disease, Institute of Regional Director of Health Services, Hambantota, Sri Lanka

  • Outpatient Department, Base Hospital, Diyathalawa, Sri Lanka

  • Outpatient Department, District Hospital, Bandarawela, Sri Lanka

  • Department of Public Health, Institute of Regional Director of Health Services, Badulla, Sri Lanka

  • Department of Public Health, Institute of Regional Director of Health Services, Hambantota, Sri Lanka

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