PRINCE KUMAR
Ranchi, March 17: A 57% increase in the out-patient was observed in the district hospitals of Jharkhand in 2018-19 as compared to 2014-15 in the performance audit conducted by the Comptroller and Auditor General of India. The audit further noticed that despite the increase in the number of patients in OPDs, each OPD clinic was being run by a single doctor leading to an increase in patient load per doctor per day which had a cascading effect in terms of low consultation time per patient.
The audit observed that the OPDs were operated for six hours a day but the department had not fixed a standard time for specialist consultation in OPDs. Audit scrutiny of records of sampled months revealed heavy patient load per day per doctor in the six test-checked district hospitals, especially in general medicine OPD which ranged between 79 and 325 patients per doctor per day.
The heavy patient load adversely impacted consultation time which ranged between one and five minutes per patient. Besides in general medicine OPD and gynaecology OPD, patient load ranged between 30 and 194 and consultation time between two and 12 minutes. Similarly, in paediatrics the OPD patient load ranged from 20 and 118 and consultation time between three and 18 minutes. Despite high patient load and low consultation time, the concerned district hospitals did not take action to deploy more than one doctor in these OPDs.
An efficient and competent OPD, commensurate with the flow of patients, is a must for providing quality health services to patients particularly poor patients who cannot afford treatment in private hospitals.
The National Institute of Public Finance and Policy had the opinion that consultation time spent with the doctor is an important attribute to determine satisfaction levels among the patients. Longer contact time has been significantly associated with better recognition and handling of physical problems and patient empowerment. Short contact time with the health care personnel is a common source of patients’ dissatisfaction with the consultation process.
