Innovative Care Model for Non Communicable Disease Patients on Patient Waiting Times in Peripheral Health Clinic in Base Hospital, Elpitiya

Long queue and long waiting time for taking appointment, consulting a doctor and to get drugs is a critical problem to patients with Non-communicable diseases who are following in government health sector. Many primary healthcare services in Sri Lanka is delivered through vertical systems, where services for routine issuing appointment, consultation and issuing drugs are co-located but use separate physical space, staff and medical records. Aim of the research leads to integration of the systems deteriorates the waiting time and reduces the worse health outcomes in the long run. A care model was developed integration of consultation and issuing drugs, with permanent issuing of routine appointment in rural healthcare settings, Elpitiya. Data on waiting time of patients during two seven-day periods before and six months after the integration were collected using a time and motion study. Statistical tests were conducted to investigate whether the two observation periods differed in operational details such as staffing, patient arrival rates, mix of patients etc. Previous level of attendance was analysed by their clinic records (before intervention). Multiple linear and logistic regression repeated measures analyses were used to assess the program's effects. Comparison of raw data showed that waiting times decreased by 7.2 hours to 3hours, after integration (p<0.01). Clinic patients attendance was remarkably improved with regular clinic service after implementing appoint system from 35%-60% to 85%-90%. The rate of clinic attendance was increased dramatically over the period from 6 months. Waiting time for attending clinic was declined and waiting in lines were avoided. Moreover, the intervention did improve clinic utilization and satisfaction. Integrating health services have the potential of reducing waiting times due to more efficient use of resources. Encouraging patients by new model is challenging and does appear to provide significant realistic benefits at rural, resource poor health settings beyond those provided by basic clinic services