1.1 Introduction
Waiting time in medical context refers to the duration patients spend waiting for healthcare services, starting from their arrival until they receive care or consultation. The impact of waiting time on patient utilization patterns has garnered increasing attention in healthcare research and practice. Patient utilization of health care services is a critical aspect of healthcare delivery, influenced by various factors, among which waiting time stands out as a significant determinant. According to Oluyemi et al., (2018), the choice of health facility varies from one person to another and from one place to another, and it also depends on certain predisposing factors to the use of health facilities (Oluyemi et al., 2018). Actual utilization of health services will differ in accordance with various factors. Although there may be health centers in some rural area, access to care might be impeded by other barriers (MACPAC, 2016; NCHS, 2016).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
Patient utilization of healthcare services is influenced by various factors, including accessibility, affordability, and quality of care. Among these factors, waiting time plays a crucial role in shaping patients' experiences and utilization patterns. Waiting time refers to the period patients spend waiting for healthcare services, including appointment scheduling delays, waiting room time, and time spent waiting to see a healthcare provider. Prolonged waiting times have been associated with decreased patient satisfaction, lower treatment adherence, and disparities in healthcare access.
Over the past health workers have been contributing immensely to the primary prevention of disease in both community and health facilities with emphasis on the front-line health workers, these are the health care providers that are available to cater for the immediate health need of the patients, according to (Agyeponget al. 2001) the Interventions to improve quality and responsiveness in healthcare have centered on professionals and frontline workers without recourse to a total system reform.
Differences in health status, based on indices such as infant mortality, young and child mortality and maternal mortality, between developed countries and developing countries have witnessed historical documentation. Within the developing countries, the phenomenon has shown aggravation as we move from urban to rural areas. Unfortunately, the causes of this disturbing reality are illnesses that can be treated and deaths that can be prevented by simple interventions but for which inappropriate structures have constituted a stumbling block. In order to justify the amount of money spent on health and the number of workers employed, serious attention is required in improving quality of healthcare services while containing costs and also in planning of health care activities and carrying out effective management functions relating to health care delivery systems (HCDS).
This cannot be done outside the imperatives of utilization. This is because utilization is the most activity-related problem, being consumer-oriented with diverse dimensions in needs, perceptions and knowledge. To the extent that utilization entails the cooperation and invitation of people outside the health system crystallizes the magnitude of the problem. Indeed, utilization as a major factor in planning any health care delivery system is validated by past and contemporary situations around the world. in the United States of America, hospitals and related health facilities require formal utilization review procedures as condition for participation under health plans and some kind of utilization review process in each institution seeking accreditation.
Carrasquillo (2013) stated that utilization is often reported as the number of services used over a period of time divided by the population denominator. Or the percentage of persons who use a certain service divided by individuals eligible to use the service. Health Care Utilization according to Carrasquillo (2013) is the quantification or description of the use of services by persons for the purpose of preventing and curing health problems, promoting maintenance of health and well- being, or obtaining information about one’s health status and prognosis. It refers to the use of health care services. Utilization can be described as the use or amount usage per unit population of health services. It stated that in health care, utilization is defined as the consumption of services or supplies such as the number of office visit a person makes per year with a health care provider, the number of prescription made or the number of days a person is hospitalized. Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Waiting Time and Patient’s Utilization of Health Care Services in the University of Calabar Teaching Hospital.
1.3 Statement of Problems
The issue of waiting time and patient utilization of health care services is multifaceted and can stem from various factors:
- Resource Allocation: Limited resources such as healthcare professionals, hospital beds, and medical equipment can lead to longer waiting times as facilities struggle to meet demand.
- Appointment Scheduling: Inefficient appointment scheduling systems can result in overbooking or underbooking, leading to either excessive waiting times or underutilization of resources.
- Patient Volume: High patient volume, especially during peak times or in areas with dense populations, can overwhelm healthcare facilities and cause longer waiting times.
- Triage Process: Ineffective triage processes can result in patients with more urgent needs waiting longer than necessary, while those with less urgent issues may be seen too quickly, leading to inefficiencies in resource utilization.
- Geographic Disparities: Disparities in healthcare access and distribution of facilities can lead to longer waiting times for patients in rural or underserved areas.
- Insurance Coverage and Affordability: Patients without adequate insurance coverage may delay seeking healthcare until their condition worsens, leading to increased demand for services and longer waiting times.
- Staffing Shortages: Shortages of healthcare professionals, particularly in certain specialties or geographic areas, can contribute to longer waiting times as facilities struggle to meet patient demand with limited staff.
Additionally, leveraging technology such as telemedicine can help alleviate waiting times by providing alternative avenues for patient consultation and care delivery. Hence, it is against this backdrop that this study aims to examine the waiting time and patient's utilization of health care services.
1.4 Aim and Objectives of Study
The aim of the study is to investigate the relationship between waiting time and patient utilization of healthcare services. In achieving this aim, the following specific objectives were laid out as follows:
- To explore strategies for optimizing resource allocation and reducing waiting times to enhance healthcare access and efficiency;
- To identify factors contributing to prolonged waiting times within healthcare settings in the area under study;
- To examine the impact of waiting times on patient satisfaction with healthcare services in the study area;
- To assess how waiting times influence patients’ decisions to seek care and adhere to treatment regimens; and
- To investigate the role of technology and process improvements in mitigating waiting times and improving patient utilization of healthcare services.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Are there factors contributing to prolonged waiting times within healthcare settings in the area under study?
- Does waiting times influence patients’ decisions to seek care and adhere to treatment regimens?
- What are the strategies for optimizing resource allocation and reducing waiting times to enhance healthcare access and efficiency?
- What is the impact of waiting times on patient satisfaction with healthcare services in the study area?
- What is the role of technology and process improvements in mitigating waiting times and improving patient utilization of healthcare services?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: Longer waiting times for healthcare services do not lead to decreased patient utilization, resulting in lower satisfaction levels and decreased adherence to treatment regimens.
- H1: Longer waiting times for healthcare services lead to decreased patient utilization, resulting in lower satisfaction levels and decreased adherence to treatment regimens.
1.7 Significance of Study
The outcome of this research study will help healthcare providers identify areas for improvement in service delivery, leading to better patient experiences. Furthermore, research on waiting times and patient utilization of healthcare services can inform the development of policies aimed at reducing waiting times, enhancing patient satisfaction, and improving overall healthcare system performance.
Moving forward, the findings of this research study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.8 Scope of Study
The scope of this research is focused on the impact of waiting time and patient's utilization of health care services in the University of Calabar Teaching Hospital.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
Waiting Time:
The duration a patient spends waiting for healthcare services, starting from the time they arrive until they receive care or are seen by a healthcare provider.
Patient Utilization:
It refers to the extent to which patients access and use healthcare services, including factors such as frequency of visits, adherence to treatment regimens, and utilization patterns over time.
Health:
Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.
Healthcare Services:
Medical, preventive, diagnostic, therapeutic, or supportive services provided by healthcare professionals or institutions to individuals or populations to promote, maintain, or restore health.
