The waiting game: determinants and effects of OPD service delays in a Tertiary Health Facility

Waiting times in outpatient departments (OPDs) significantly affect patient satisfaction, service utilisation, and healthcare outcomes. This study examined the determinants of waiting times and their implications for patients accessing OPD services at Korle-Bu Teaching Hospital in Ghana.

A cross-sectional study was conducted among 274 adult patients attending selected outpatient departments (OPDs) of the Korle-Bu Teaching Hospital in Accra, Ghana. A multistage sampling technique was used: three OPD clinics were purposively selected, patient sessions were randomly chosen, and participants were systematically sampled from each session. Data were collected using a structured, pretested questionnaire administered by trained research assistants. The questionnaire captured sociodemographic characteristics, waiting times, factors contributing to delays, and the effects of long waits on service utilisation. Data were analyzed using Stata 17. Descriptive statistics summarised participants' characteristics and waiting times, while chi-square tests examined associations among categorical variables. Multiple linear regression was performed to identify determinants of waiting time, controlling for potential confounders. Model fit was assessed using standard diagnostic tests, and results were presented with coefficients and 95% confidence intervals. Ethical approval was obtained from the Korle-Bu Teaching Hospital, and informed consent was obtained from all participants.

A total of 274 patients participated in the study, with a mean age of 34.1 years (±11.3); 51.8% were female, 61.3% married, and 38.7% had no formal education. Employment included civil servants (31.8%), farmers (23.7%), and traders (16.8%), while 45.3% had health insurance. Most visits occurred on Monday (34.3%), and early-morning arrivals were common (43.4%). Overall, 56.4% of patients experienced long waiting times (≥120 minutes), with median waiting times of 16 minutes at registration, 30 minutes for laboratory services, and 32 minutes for other diagnostics. Multivariable analysis showed that female sex, lower educational attainment, Monday visits, and early morning arrivals were significantly associated with longer waiting times. Employment status and insurance coverage were not statistically significant, though civil servants and insured patients tended to experience shorter waits. Prolonged waiting times were linked to missed appointments (53.4%), negative health impacts (39.7%), psychological effects, and low satisfaction, with only 31.2% willing to reuse hospital services.

Interventions should include enhanced patient education, gender-sensitive practices, expanded weekend services, optimisedp scheduling, and digital queue management systems. Policymakers and hospital administrators must priioritise these strategies to reduce waiting times, improve patient satisfaction, and enhance healthcare outcomes. Though the study offers some insights into the determinants of waiting times, it also has some limitations. The study was conducted at a single tertiary hospital, limiting generalizability. Some potential determinants, such as patient health status, severity of illness, and organisational factors, were not assessed. Additionally, the cross-sectional design precludes causal inferences.