Assessment of Hospital Overcrowding Perceptions and Outpatient Care Quality Among Hypertensive Patients in Mampong,...

Hospital overcrowding is a common challenge in low- and middle-income countries and tends to reduce the quality of outpatient care for patients with chronic conditions such as hypertension. Evidence in municipal health settings in Ghana is limited. This study assessed the association between patients' perceptions of hospital overcrowding and their perceived outpatient care quality among hypertensive patients in Mampong Ashanti Municipality, Ghana.

An analytical cross-sectional study was conducted among 342 hypertensive outpatients at Mampong Municipal Hospital and Kofiase Health Centre (October-December 2025). Participants were selected using systematic random sampling with proportional allocation. Data were collected using structured questionnaires assessing perceived hospital overcrowding and outpatient service quality (adapted SERVQUAL). Descriptive statistics summarized participant characteristics, Chi-square tests examined associations, and multivariable logistic regression identified predictors of perceived outpatient care quality.

A total of 61.7% of respondents reported moderate to high perceived overcrowding. Participants were predominantly ≥ 60 years (52.1%), female (62.6%), with comorbidities (58.5%). Higher perceived overcrowding was associated with poorer outpatient care quality. Each one-unit increase in perceived overcrowding score was associated with 20.8% lower odds of reporting good outpatient care quality (AOR = 0.79; 95% CI: 0.75-0.84). Patients aged 40-49 years (AOR = 9.32; 95% CI: 2.57-33.88; p < 0.001) and 50-59 years (AOR = 3.02; 95% CI: 1.04-8.82; p = 0.04) were more likely to report good care quality compared with those ≥ 70 years. Lower education attainment, income (< GHS 1000), lack of health insurance, and single marital status were associated with lower odds of perceived outpatient care quality.

Perceived hospital overcrowding is associated with lower perception of outpatient care quality among hypertensive patients. Interventions to decongest outpatient departments and address socioeconomic disparities are essential to improve hypertension care.