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Volume 12, Number 1, 6~16, Factors influencing consultation time and waiting time of ambulatory patients in a tertiary teaching hospital Jee-In Hwang College of Nursing Science, Kyung Hee University : Tel) 02-961-9145, E-mail) jihwang@khu.ac.kr 6

Abstract Objectives : The purpose of this study was to identify the characteristics influencing consultation and waiting time in ambulatory patients. Methods : This study was conducted in a tertiary teaching hospital. Subjects were a total of 10,383 ambulatory patients. Consultation time was measured by time spent for meeting with his/her physician per patient. Waiting time was defined as the time difference between each patient's reserved time and time to meet with his/her physician for ambulatory care. Multiple regression analyses were performed to determine the factors influencing consultation and waiting time. Results : Consultation time was different according to patient' age, previous experience of clinic visit, recent admission history, medical department, specialist care, type of reservation, and day of the week. Significant factors influencing waiting time were patient' age, residential area, previous experience of clinic visit, recent admission history, medical department, specialist care, time spent after ambulatory care begins, and day of the week. Conclusions : The medical department was the strongest factor affecting both consultation time and waiting time. The ambulatory reservation management systems should take into account patient characteristics as well as care-related features. Key Words: Ambulatory care; Consultations; Waiting Lists; Outpatient Clinics, Hospital 7

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Gender Female 5,426 52.3 3.7 3.4 0.03 NS 32.3 27.8-0.11 NS Male 4,957 47.7 3.7 3.1 32.4 27.6 Age -24 306 3.0 4.7 5.4 19.49 <.0001 38.8 31.7 40.00 <.0001 25-44 2,060 19.8 3.9 3.6 36.7 29.4 45-64 5,192 50.0 3.5 3.1 32.2 27.4 65-2,825 27.2 3.5 3.0 28.6 25.9 Residential Seoul 5,969 57.5 3.6 3.2 3.16 0.043 31.4 27.4 12.56 <.0001 area Kyunggi 2,392 23.0 3.6 3.2 33.8 28.1 Others 1,828 17.9 3.8 3.5 34.6 28.6 Kangwon 193 1.9 3.7 3.8 32.8 29.2 Chungchoung 624 6.0 3.7 3.4 34.4 29.7 Kyungbuk 300 2.9 4.4 4.4 35.8 26.4 Kyungnam 225 2.2 3.6 2.5 32.9 28.1 Chula 406 3.9 3.8 3.4 35.2 27.9 Jeju 80 0.8 4.1 2.9 38.1 30.1 missing 194 1.9 2.4 2.0 21.8 21.4 Number 0 5,773 55.6 3.4 3.1 56.18 <.0001 30.5 27.2 30.07 <.0001 of 1 2,525 24.3 3.8 3.2 33.9 28.1 admission* 2 2,085 20.1 4.3 3.7 35.5 28.5 Number 0 7,779 74.9 3.5 3.2 62.37 <.0001 30.6 27.0 60.49 <.0001 of recent 1 1,758 16.9 4.1 3.5 37.2 29.2 admission 2 846 8.2 4.5 3.6 38.1 29.2 Visiting A 515 5.0 5.2 3.8 112.23 <.0001 36.7 29.3 9.65 <.0001 experience B 9,278 89.4 3.5 3.1 31.9 27.5 C 590 5.7 4.9 4.0 34.8 29.3 Total 10,383 100.0 3.7 3.3 32.3 27.7 * : Number of admission during the last year : A-New patients at the study hospital, B-Patients who had visited at the study hospital before C-New patients at the clinical department, but those who had visited at the study hospital before 9

Reserved No 99 1.0 6.0 5.7 4.09 <.0001 31.0 32.2-0.4 0.6884 care Yes 10,284 99.1 3.6 3.2 32.3 27.7 Reservation Routine 10,290 99.1 3.6 3.3 2.7 0.0082 32.3 27.7 0.15 0.8777 type Not routine 93 0.9 5.0 4.9 32.8 29.4 Specialist care Yes 9,929 95.6 3.6 3.3 2.93 0.003 32.5 27.8-3.97 <.0001 No 454 4.4 4.1 3.4 27.8 24.6 Time spent 0-1 3,106 29.9 3.5 2.9 5.17 0.0014 26.1 24.0 163.12 <.0001 after clinic 1-2 3,842 37.0 3.7 3.3 30.4 26.0 begins 2-3 2,984 28.7 3.8 3.6 39.4 29.7 (hr) 3-4 451 4.3 3.7 2.7 45.0 36.7 Reservation 9:00 941 9.1 3.3 2.8 9.75 <.0001 26.4 23.9 38.55 <.0001 time 9:30 1,238 11.9 3.3 2.6 25.2 24.2 10:00 1,313 12.7 3.5 2.9 29.4 24.5 10:30 1,245 12.0 3.5 3.1 32.5 26.5 11:00 1,268 12.2 3.6 3.4 39.0 27.8 11:30 958 9.2 3.6 3.1 37.8 29.9 12:00 174 1.7 3.2 2.1 39.1 32.1 12:30 114 1.1 3.5 2.2 46.1 33.9 13:00 314 3.0 3.5 2.8 27.7 23.8 13:30 613 5.9 4.1 3.6 26.6 23.8 14:00 741 7.1 4.1 3.8 29.7 26.9 14:30 543 5.2 4.4 4.0 28.8 26.9 15:00 455 4.4 4.6 4.6 40.2 30.2 15:30 303 2.9 4.0 3.6 45.3 34.8 16:00 163 1.6 4.2 3.4 50.6 42.0 Day Monday 2,045 19.7 3.6 3.2 8.5 <.0001 30.4 27.9 26.97 <.0001 Tuesday 2,509 24.2 3.4 2.8 36.1 28.6 Wednesday 2,175 21.0 3.6 3.6 28.6 24.5 Thursday 1,156 11.1 3.7 3.1 31.6 27.8 Friday 1,722 16.6 4.0 3.9 31.7 27.9 Saturday 776 7.5 3.9 2.5 38.2 30.0 Clinical Infection 106 1.0 9.1 5.7 103.82 <.0001 47.7 38.2 79.85 <.0001 department Endoclinology 1,693 16.3 3.2 3.4 22.3 22.4 Gerontology 253 2.4 3.5 2.8 14.1 15.2 Rheumatology 536 5.2 5.6 4.9 41.1 32.1 Gastroenterology 1,988 19.2 3.0 2.2 32.5 27.4 Cardiology 1,965 18.9 2.8 2.3 29.1 22.6 Nephrology 922 8.9 3.6 2.9 35.6 28.6 Allergy 675 6.5 4.2 3.4 40.6 27.3 Oncology 1,335 12.9 4.4 3.9 41.7 31.0 Pulmonology 910 8.8 4.4 3.0 32.5 29.9 Total 10,383 100.0 3.7 3.3 32.3 27.7 10

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Constant 6.63 0.36 18.52 <.0001 Age -24 0.62 0.18 3.43 0.00 25-44 0.06 0.08 0.80 0.43 45- Residential area Other areas 0.09 0.08 1.08 0.28 Seoul, Kyunggi Previous visiting experience Yes -1.55 0.10-15.54 <.0001 No Number of recent admission 0.21 0.03 7.64 <.0001 Specialist care -1.04 0.15-6.89 <.0001 Reserved care -1.44 0.31-4.58 <.0001 Day Friday 0.29 0.09 3.45 0.00 Monday, Thursday, Saturday 0.02 0.07 0.33 0.74 Tuesday, Wednesday Time spent after ambulatory care begins 0.05 0.04 1.34 0.18 Clinical department Infection 5.77 0.30 18.97 <.0001 Rheumatology 2.54 0.14 17.95 <.0001 Pulmonology, oncology, allergy 1.23 0.07 17.44 <.0001 Endoclinology, Gerontology, Gastroenterology, Cardiology, Nephrology R-Square 0.11 Adj R-Square 0.11 F value 102.6 <.0001 12

Constant -3.37 2.38-1.41 0.16 Age -44 5.30 0.74 7.13 <.0001 45-64 2.52 0.61 4.11 <.0001 65- Residential area Kyunggi, Other areas 1.20 0.52 2.30 0.02 Seoul Previous visiting experience Yes -3.68 0.84-4.38 <.0001 No Number of recent admission 1.06 0.23 4.53 <.0001 Specialist care 6.98 1.34 5.22 <.0001 Time spent after ambulatory care begins 6.12 0.30 20.67 <.0001 Day Tuesday 5.06 0.61 8.27 <.0001 Saturday 6.00 1.05 5.73 <.0001 Monday, Wednesday, Thursday, Friday Clinical department Endoclinology 5.18 1.78 2.92 0.00 Nephrology, gastroenterology, pulmonology, cardiology 14.10 1.69 8.32 <.0001 Rheumatology, allergy, oncology 22.58 1.75 12.93 <.0001 Infection 28.01 3.04 9.21 <.0001 Gerontology R-Square 0.12 Adj R-Square 0.12 F value 107.9 <.0001 13

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