Analysis of Outpatient Waiting Time Determinants in Hospitals Based on the Donabedian Framework
Abstract
Waiting time is one of the indicators in evaluating the quality of outpatient services in hospitals. Long waiting times are often the main complaint of patients and have the potential to reduce satisfaction and effectiveness of services. This article aims to review the available literature on patient waiting times and identify factors that contribute to waiting times for outpatient services. The method used is a Systematic Literature Review using the Preferred Reporting Items for Systematic Reviews (PRISMA) flow by collecting articles from the Google Scholar and PubMed databases published between 2019 and 2024 with the keywords " outpatient", "waiting time" and "hospital", as well as in Indonesian: "waktu tunggu, perawatan jalan" and "poliklinik". Based on the analysis results, 20 articles were selected from the 130 articles selected that met the inclusion criteria and were subsequently analysed and classified using the Donabedian theoretical framework, which consists of three components: structure, process, and outcome. The analysis results indicate that structural factors, such as limited medical personnel, inadequate infrastructure, and inefficient queuing systems, are the primary causes. In the process aspect, doctor delays, lengthy administrative processes, and a lack of service system integration also contribute to lengthening waiting times. Meanwhile, outcome factors are closely related to patient perceptions and satisfaction levels. The study's conclusions suggest that improving outpatient wait times necessitates a comprehensive approach that encompasses enhancing service structure, process efficiency, and prioritising patient outcomes.
References
Abdulai Alpha Jalloh, Laurine Chikodiri Nwosu, & SB (2020). Evaluation of waiting time and associated factors influencing patient satisfaction levels in an outpatient department: A case study of government hospital in Sierra. 1–9.
Agustina, F., Adyas, A., Djamil, A., Pramudho, PK, & Rahayu, D. (2023). Factors Associated with Waiting Time for Outpatients. Malahayati Nursing Journal, 5 (9), 3211–3228. https://doi.org/10.33024/mnj.v5i9.7471
Al-Harajin, RS, Al-Subaie, SA, & Elzubair, AG (2019). The association between waiting time and patient satisfaction in outpatient clinics: Findings from a tertiary care hospital in Saudi Arabia. Journal of Family and Community Medicine, 26 (1), 17–22. https://doi.org/10.4103/jfcm.JFCM_14_18
Biya, M., Gezahagn, M., Birhanu, B., Yitbarek, K., Getachew, N., & Beyene, W. (2022). Waiting time and its associated factors in patients presenting to outpatient departments at Public Hospitals of Jimma Zone, Southwest Ethiopia. BMC Health Services Research, 22 (1), 1–8. https://doi.org/10.1186/s12913-022-07502-8
Dewi, S., Machmud, R., & Lestari, Y. (2020). Analysis of Outpatient Waiting Times at Dr. Achmad Darwis Suliki Regional General Hospital in 2019. Andalas Health Journal, 8 (4), 175–184. https://doi.org/10.25077/jka.v8i4.1137
Dwi, MA, Paganini, R., Limisran, L., & Yulianto, N. (2024). Paganini, M. Ariq Dwi Rizky, Limisran Limisran, and Nova Yulianto. Review of BPJS Patient Service Waiting Time in Outpatient Services at Siti Khadijah Islamic Hospital, Palembang. Quantum Wellness: Journal of Health Sciences 1.4 (2024): 54–63. Https://Journal.Lpkd.or.Id/Index.Php/QuWell .
Eddy, KE, Vogel, JP, Scott, N., Fetene, D., Tidhar, T., Oladapo, OT, Piaggio, G., Nguyen, MH, Althabe, F., Bahl, R., Rao, SPN, De Costa, A., Gupta, S., Baqui, AH, Shahidullah, M., Chowdhury, SB, Ahmed, S., Sultana, S., Jaben, IA, … Raza, F. (2022). Antenatal dexamethasone for improving preterm newborn outcomes in low-resource countries: a cost-effectiveness analysis of the WHO ACTION-I trial. The Lancet Global Health , 10 (10), e1523–e1533. https://doi.org/10.1016/S2214-109X(22)00340-0
Fauziyyah, S. (2021). Analysis of Service Waiting Time on Patient Satisfaction at Cempaka Putih Regional Hospital in 2020. Indonesian Journal of Hospital Management and Administration (MARSI) , 5 (1), 89–96. https://doi.org/10.52643/marsi.v5i1.1299
Insani, RI, Sriatmi, A., & Fatmasari, EY (2020). Aspects of Waiting Time Dimensions that Influence Outpatient BPJS Patient Satisfaction at the Eye Polyclinic of William Booth Hospital, Semarang. Student Scientific Journal , 10 (3), 84–86.
Iswanto, AH (2022). Reducing Waiting Times in Hospital Outpatient Units. Scientific Journal of Batanghari Jambi University , 22 (1), 482. https://doi.org/10.33087/jiubj.v22i1.2040
Jalili, R., Mohebbi, M., Asefzadeh, S., & Mohebbi, M. (2020). Evaluation of Waiting Time and Satisfaction in Outpatients in Imam Hossein Polyclinic of Zanjan Using Patient-Pathway Analysis. Preventive Care In Nursing and Midwifery Journal , 10 (3), 34–41. https://doi.org/10.52547/pcnm.10.3.34
Mahadewi, EP, Heryana, A., Kurniawati, Y., & Ayuba, I. (2019). Analysis of Waiting Time for Lung Polyclinic Service at The Regional General Hospital (RSUD) Tangerang. Gorontalo Journal of Public Health , 2 (1), 110–119.
Manyering, GG, Wartiningsih, M., Messakh, BD, Tabita, H., & Silitonga, H. (2023). The relationship between service waiting time and patient satisfaction levels . 17 (2), 93–101.
Muen, S., Wanyonyi, S. W., Marangu, D. M., & Mong'are, O. D. (2019). Determinants and Management of Patient Waiting Time in the General Outpatient Department in Kibabii University Health Clinic, Kenya. Asian Journal of Probability and Statistics , 2 (4), 1–9. https://doi.org/10.9734/ajpas/2018/v2i428794
Ndu, IK, Osuorah, CDI, Amadi, OF, Ekwochi, U., Ekeh, BC, Nduagubam, OC, & Okeke, IB (2020). Evaluation of wait time in the children's emergency and outpatient units of a tertiary hospital in Southeast Nigeria. Journal of Emergencies, Trauma and Shock , 13 (1), 78–83. https://doi.org/10.4103/JETS.JETS_139_18
Nguyen, D.-H., Tran, D.-V., Vo, H.-L., Nguyen Si Anh, H., Doan, T.-N.-H., & Nguyen, T.-H.-T. (2020). Outpatient Waiting Time at Vietnam Health Facilities: Policy Implications for Medical Examination Procedures. Healthcare , 8 (1), 63. https://doi.org/10.3390/healthcare8010063
Purwoko, P., & Nurwahyuni, A. (2022). Factors Affecting Outpatient Waiting Time (Wtrj) in Hospitals a. Indonesian Scientific Journal , 7 (11), 16557– 16563.
Sarwat, A. (2022). the Effects of Waiting Time and Satisfaction Among Patients Visiting Medical Outpatient Department of a Tertiary Care Hospital Place and Duration of the Study Subjects and Methods. J Pak Psychiatr Soc , 18 (3).
Shavira Aprilianti, N., & Ulfah, A. (2024). Review of Outpatient Waiting Times at the Neurology Polyclinic to Improve the Quality of Health Services at Majalaya Regional Hospital. Prepotif: Journal of Public Health , 8 (2), 3704–3710. https://doi.org/10.31004/prepotif.v8i2.31666
Sholihah, N., & Khodijah Parinduri, S. (2021). The Relationship between Outpatient Waiting Time and BPJS Patient Satisfaction at the Heart Polyclinic of Bogor Islamic Hospital in 2019. Promotor , 3 (6), 585–597. https://doi.org/10.32832/pro.v3i6.5565
Sumayku, IM, Pandelaki, K., Kandou, GD, Wahongan, PG, & Nelwan, JE (2022). Analysis of Factors Associated with Waiting Time for Services at the Outpatient Polyclinic of Sentra Medika Hospital, North Minahasa Regency. E-CliniC , 11 (1), 1–10. https://doi.org/10.35790/ecl.v11i1.44251
Toga-Sato, S., Tosaki, T., Kondo, M., Tsunekawa, S., Kato, Y., Nakamura, J., & Kamiya, H. (2021). Impact of actual waiting time and perceived waiting time on treatment satisfaction in patients receiving outpatient diabetes care. Diabetology International , 12 (3), 293–300. https://doi.org/10.1007/s13340-020-00486-y
Wardani silvia intan. (2024). Determinants of Outpatient Waiting Time at Lawang Malang Hospital Determinants of Outpatient Waiting Time at Lawang Malang Hospital Intan Wardani Kusuma Widyawati Health Administration STIKES Kesdam IX / Udayana. Journal of Medical Records and Health Information , 7 (2), 113–126.
Wulandari, AD, Irwan Endrayanto Aluicius, & Firman Setya Wardhana. (2022). Queue Modeling and Simulation to Improve Waiting Time at the Vitreoretinal Polyclinic of the "Dr. Yap" Eye Hospital, Yogyakarta. The Indonesian Journal of Health Service Management , 25 (01). https://doi.org/10.22146/jmpk.v25i01.4771
Zein, ER, & Mujizah, A. (2024). Review of Factors Influencing Waiting Times for Outpatient Registration Services at DKT Sidoarjo Hospital. Imelda Scientific Journal of Health Recording and Information (JIPIKI) , 9 (1), 80–89. https://doi.org/10.52943/jipiki.v9i1.1599.
Copyright (c) 2025 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
