Daniels Johann, Zweigenthal Virginia, Reagon Gavin
City Health, Cape Town.
School of Public Health and Family Medicine, University of Cape Town.
J Public Health Afr. 2017 Sep 21;8(1):639. doi: 10.4081/jphia.2017.639. eCollection 2017 Jun 23.
A waiting time survey (WTS) conducted in several clinics in Cape Town, South Africa provided recommendations on how to shorten waiting times (WT). A follow-up study was conducted to assess whether WT had reduced. Using a stratified sample of 22 clinics, a before and after study design assessed changes in WT. The WT was measured and perceptions of clinic managers were elicited, about the previous survey's recommendations. The overall median WT decreased by 21 minutes (95%CI: 11.77-30.23), a 28% decrease from the previous WTS. Although no specific factor was associated with decreases in WT, implementation of recommendations to reduce WT was 2.67 times (95%CI: 1.33-5.40) more likely amongst those who received written recommendations and 2.3 times (95%CI: 1.28-4.19) more likely amongst managers with 5 or more years' experience. The decrease in WT found demonstrates the utility of a WTS in busy urban clinics in developing country contexts. Experienced facility managers who timeously receive customised reports of their clinic's performance are more likely to implement changes that positively impact on reducing WT.
在南非开普敦的几家诊所进行的一项候诊时间调查（WTS）就如何缩短候诊时间（WT）提出了建议。随后开展了一项后续研究，以评估候诊时间是否有所减少。采用分层抽样选取了22家诊所，通过前后对比研究设计评估候诊时间的变化。测量了候诊时间，并就诊所管理人员对之前调查建议的看法进行了询问。总体中位候诊时间减少了21分钟（95%置信区间：11.77 - 30.23），较之前的候诊时间调查减少了28%。虽然没有特定因素与候诊时间的减少相关，但在收到书面建议的人群中，实施缩短候诊时间建议的可能性是未收到者的2.67倍（95%置信区间：1.33 - 5.40），在有5年或以上工作经验的管理人员中，这一可能性是其他人的2.3倍（95%置信区间：1.28 - 4.19）。所发现的候诊时间减少情况表明，候诊时间调查在发展中国家背景下繁忙的城市诊所中具有实用性。及时收到其诊所表现定制报告的经验丰富的机构管理人员更有可能实施对缩短候诊时间有积极影响的变革。
