Meta-Analysis: Effects of Gender, Waiting Time, Visits, and Insurance on Outpatient Satisfaction with Health Services
DOI:
https://doi.org/10.26911/thejhpm.¬2025.10.01.02Abstract
Background: Patient satisfaction is the result of the service process felt by the patient, overall satisfaction arises from the patient's evaluation of the experience or as an interaction, including the availability of health services provided by officers (health workers), so that patient satisfaction can be used to assess the quality of services received by the patient. This study aims to estimate the magnitude of the influence of gender, waiting time, visits, and insurance on health service satisfaction.
Subjects and Method: Systematic review and meta-analysis using PRISMA flow charts and PICO models. Population: outpatients. Intervention: Female, long waiting time, already visited, using insurance. Comparison: Male, short waiting time, first time visit, and not using insurance. Outcome: Outpatient satisfaction with health services. The online databases used were Google Scholar, Biomedcentral, Taylor & Francis and Plos with the keywords gender, waiting time, visits, insurance, outpatient satisfaction, cross-sectional and aOR. Inclusion criteria were full text articles with cross-sectional use of multivariate analysis that included aOR and were published from 2014-2024. Data analysis using the RevMan 5.3 application.
Result: Twelve primary studies were used to analyze gender and patient satisfaction with health services. Women had satisfaction with health services 1.19 times compared to men (aOR= 1.19; 95% CI=1.11 to 1.28; p<0.001). Ten primary studies were used to analyze insurance and patient satisfaction with health services. Patients who have insurance are 1.23 times more satisfied with health services than those who do not have insurance (aOR= 1.23; 95% CI=1.09 to 1.40; p<0.001). Seven primary studies were used to analyze waiting times and patient satisfaction with health services. Patients who experienced short waiting times were 0.30 times more satisfied with health services compared to those with long waiting times (aOR=0.30; 95% CI=0.21 to 0.44; p<0.001). Seven primary studies were used to analyze visit frequency and patient satisfaction with health services. Patients who have visited are 2.96 times more satisfied with health services than patients who are visiting for the first time (aOR=2.96; 95% CI=2.60 to 3.37; p<0.001).
Conclusion: Female gender, short waiting times, repeat visits and insurance in increasing outpatient satisfaction with health services.
Keywords:
gender, waiting time, visits, insurance, outpatient satisfactionReferences
Alarcon-Ruiz, Christoper A, Heredia, Paula, Taype-Rondan A (2019). Association of waiting and consultation time with patient satisfaction: Secondary-data analysis of a national survey in Peruvian ambulatory care facilities. BMC Health Serv Res, 19(1): 439. https://doi.org/10.1186/s12913-019-4288-6.
Ayele, Wolde M, Ewunetu, Abdurahman, Chanie, Muluken G (2022). Level of satisfaction and associated factors among patients attending outpatient departments of South Wollo health facilities, Ethiopia. PLOS Glob Public Heal, 2(7): e0000761. https://doi.org-/10.1371/journal.pgph.0000761.
Babore, Getachew O, Ashine, Taye MH, Asnakech Z, Habebo, Teshome, Tesfaye (2023). Client satisfaction and asso¬ciated factors towards the health ser¬vice provided to members of a com¬munity-based health insurance scheme in Southern Ethiopia. Front Health Serv 3(1): 1237895. https://doi.org/-10.3389/frhs.2023.1237895.
Batbaatar, Enkhjargal D, Javkhlanbayar, Luvsannyam, Ariunbat S, Matteo MA, Pietro (2017). Determinants of patient satisfaction: A systematic review’, Perspectivesin Pub Health, 137(2): 89-101. https://doi.org/10.1177/-1757913¬91¬6634136.
Berehe, Tirhas T, Bekele, Getabalew E, Yimer, Yimer S, Lozza, Taye Z (2018). Assessment of clients satisfaction with outpatient services at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia. BMC Res Notes, 11(1): 507. https://doi.org/10.1186/s13104-018-3603-3.
Chandra, Swastika, Ward, Paul, Moham-mad¬nezhad, Masoud (2021). Investigating patient trust in doctors: A cross-sectio¬nal survey of out-patient depart¬ments in Fiji. Int Q Community Health Educ, 41(4): 369-377. https://doi.org/10.1-177/0272684X20967602.
Cosker-Rowland, Rach (2023). Recent work on gender identity and gender. Analysis, 83(4): 801-820. https:/¬/-doi.org/10.1093/analys/anad027.
Desta H, Tesfay B, Solomon H (2018). Assess¬ment of patients’ satisfaction and associated factors among out-patients received mental health ser-vices at public hospitals of Mekelle Town, Northern Ethiopia. Int J Ment Health Syst, 12(1): 38. https://doi.org¬/¬10.1186/s13033-018-0217-z.
Eshetie, Gojjam, Feleke, Amsalu G, Muluken (2020). Patient satisfaction and asso¬ciated factors among outpatient health service users at primary hospitals of North Gondar, Northwest Ethiopia, 2016. Adv Public Health, 1: 6102938. https://doi.org/10.1155/2020/6102938.
Fu, Shui W, Xian Guo, Zhang, Liang W, Li FL, Zhang MH, Qi L (2021). Service quality improvement of outpatient blood collection by lean management. Patient Prefer Adherence, 15: 1537-1543. https://doi.org/10.2147/PPA.S320163.
Geberu, Demiss MB, Gashaw AG, Tsegaye M, Tesfaye H (2019). Factors of patient satisfaction in adult outpatient depart¬ments of private wing and regular services in public hospitals of Addis Ababa, Ethiopia: A comparative cross-sectional study. BMC Health Serv Res, 19(1): 869. https://doi.org/10.¬1186/¬s1¬2913-019- 4685-x.
Goben, Kebebew WA, Endalamaw SA, Samuel T (2020). Patient satisfaction and associated factors among psy-chiatry outpatients of St Paulo’s Hospital, Ethiopia. Gen Psychiatry, 33(1): e100120. https://doi.org/10.-1136/¬gpsych-2019- 100120.
Guadie, Yisak GK, Alemu KA, Kedir SY, Ermias S (2022). Patient’s satisfaction in physiotherapy outpatient depart-ments of Amhara regional comprehen¬sive specialized hospitals, Ethiopia. BMC Health Serv Res, 22(1): 1011. https://doi.org/10.1186/s12913-022-08338-y.
Hailie, Mulugeta TH, Seid LT, Minwuyelet M (2021). Client satisfaction on commu¬nity based health insurance scheme and associated factors at Boru Meda Hospital, Northeast, Ethiopia: institu¬tional based cross-sectional study. BMC Health Serv Res, 21(1): 1287. https://doi.org/10.1186/s12913-021-07223-4.
Hasen, Gemmechu N, Bedaso (2021). Pati-ents satisfaction with pharmaceutical care and associated factors in the southwestern Ethiopia. Patient Prefer Adherence, 15(1): 2155-2163. https://¬doi.org/10.2147/PPA.S332489.
Inverso, Gino M, Brandon A. Aizer, Ayal A. Donoff, R. Bruce C, Sung K (2016). Health insurance affects head and neck cancer treatment patterns and out¬comes. J Oral Maxillofac Surg, 74(6): 1241-1247. https://doi.org/-10.¬1016/¬j.joms.2015.12.023.
Jayantkumar, Patel HD, Patel N (2019). Study on patient satisfaction of out-patient department in ESI Hospitals at Ahmedabad, Vadodara, and Surat in state of Gujarat. Int J Healthc Manag, 12(4): 259-264. https://doi.org/10.-1080/20479700.2017.1398441.
Karoni, Hanna FB, Getasew MA, Muluken K, Ayele SA, Amare AT, Gebiyaw W (2020). Maternal satisfaction among vaginal and cesarean section delivery care services in Bahir Dar city health facilities, Northwest Ethiopia: A faci-lity-based comparative cross-sectional study. BMC Pregnancy Child¬birth, 20(1): 473. https://doi.org/10.1¬186/s-12¬884-020-03170-w.
Ke, Li C, Jingshu J, Jia K, Pan C, Xueqin M, Zongfu L, Bing (2020). Outpatients’ satisfaction in the context of 10 years of health-care reform: A cross-sectional study of tertiary hospitals in Shiyan, China. Patient Prefer Adherence, 14: 191-202. https://doi.org/10.2147/PPA.S233472.
Kebede, Hussien T, Tessema N, Mogesie Z, Yosef (2021). Patient satisfaction towards outpatient pharmacy services and associated factors at dessie town public hospitals, south Wollo, north-east Ethiopia. Patient Prefer Adhe-rence, 15: 87-97. https://doi.org/1-0.2147/PPA.S287948.
Kidanemariam, Gebregziabher G, Hailemi-kael D, Ebud AA, Kahsay (2023). Improving Patient Satisfaction and Associated Factors at Outpatient Depart¬ment in General Hospitals of Central Zone, Tigray, Northern Ethiopia, June 2018-August 2019: Pre- and Postinterventional Study. Biomed Res Int, 2023: 6685598. https://-doi.org/10.1155/2023/6685598.
Liang, Huigang X, Yajiong Z, Zhi R (2021). Patient satisfaction in China: A national survey of inpatients and outpatients. BMJ Open, 11(9): e049570. https://-doi.org/10.1136/bmjopen-2021-0495-70.
Melesse, Dersolign T, Mehret M, Bahiru (2022). Level of Clients’ Satisfaction and Associated Factors with the Service of Out-Patient Department in Dilla University Referral Hospital, Southern Ethiopia, 2021. Adv Public Heal, 2022(1): 6451755. https://doi.org/10.-1155/2022/6451755.
Mesfin, Dereje G, Tadiwos (2019). Patient satisfaction and associated factors with services provided at outpatient depart¬ments. Int J Public Health, 8(4): 406. https://doi.org/10.11591/ijphs.v8i4.20375.
Mezemir, Rahel (2014). Patients’ Satisfaction and its determinants in Outpatient Department of Deberebirhan Referral Hospital, North Shoa, Ethiopia. Int. J. Econ. Manag. Sci., 03(03): 000191. https://doi.org/10.4172/2162-6359.1-000191.
Nohria, Raman X, Nan G, Rubeen D, Mari LS, Cara N, Keith B, Elena (2022). Implementing Health Related Social Needs Screening in an Outpatient Clinic. J Prim Care Community Heal, 13: 21501319221118809. https://doi.-org/¬10.1177/21501319221118809.
Pringgayuda, Fitria H, Faridah Alsaidi, Nahla AY (2022). Waiting Time of Patients in Outpatient Hospital Before and After Pandemic Covid 19: A Literature Re¬view. J Heal Sci Prev, 6(1): 36-43. https://doi.org/10.29080/jhsp.v6i1.705.
Shewasinad, Sisay S, Alemayehu (2018). Assessment of Adult Patient Satisfac-tion and Associated Factors with Nursing Care Among Admitted Patient in Medical, Surgical, Obstetrics and Gynecology Ward in Mizan-Aman General Hospital, Bonga and Tepi Hospitals, Southwest Ethiopia 2016. JOJ Nurse Heal Care, 8(5). https://-doi.org/10.19080/JOJNHC.2018.08.555748.
Sleath, Betsy S, Robyn B, Susan JC, Delesha MM, Kelly WH, Mary ET, Gail L, Scott G, Annette LR Alan L (2015). Patient Question-Asking About Glaucoma and Glaucoma Medications During Video¬taped Medical Visits. Health Commun, 30(7): 660-668. https://¬doi.org/¬10.-1080/10410236.2014.888387.
Thanh, Nguyen MA, Bui TX, Chu HQA, Pham T, Pham H, Thi PT, Nguyen HQ, Cao H, Vu T, Thanh H, Phung (2022). Patient Satisfaction with healthcare service quality and its associated factors at one polyclinic in Hanoi, Vietnam. Int J Public Health, 67(1): 1605055. -https://doi.org/10.3389/ijph.2022.1605055.
Tume, SM, Salgedo WB, Jaleta FT (2015). Patient satisfaction and associated factors with outpatient medical services in rural primary healthcare facilities, Ilubabor zone, Oromiya region, south West Ethiopia. Int J Curr Res, 7(9): 20245-20251. http://www.journalcr-a.com/sites/default/files/issue-pdf/1-0202.pdf.
Ukizentaburuwe JMV, Kagimbangabo B, Safari E (2021). Waiting time and associated factors among outpatients at Kibungo Referral Hospital-Rwanda. Rwanda Medical Journal, 78(2): 40-48. https://doaj.org/article/4a86c91e78414a35a837ca372aec694d.
Yimer, Solomon Y, Zegeye G, Wondale M, Tesfa F, Wubalem B, Habte M, Melak G, Asmamaw B, Amsalu (2016). Satis-faction and associated factors of out-patient psychiatric service con¬sumers in Ethiopia. Patient Prefer. Adherence, 10: 1847-1852. https://doi.org/10.2¬147¬/PPA.S115767