OPD Capacity in the 21st Century: A Review of the Factors that Increase Patient Waiting Time


  • Maame Fosua Afrifa-Minka Research Scholar, School of Management & Commerce, Sanskriti University, Mathura, Uttar Pradesh, India, Sanskriti University, 28, K.M. Stone, Chennai – Delhi Hwy, near Punjab National Bank, Chhata Rural, Uttar Pradesh 281401, India
  • Anubhav Sony Assistant Professor, School of Management & Commerce, Sanskriti University, Mathura, Uttar Pradesh, India


OPD capacity, patient waiting time, OPD queue, patient flow, outpatient management


The OPD is the first point of call for patients in the hospital and requires operating at optimum capacity to ensure the smooth running of the hospital to maintain a good image to the public. Patients as individuals who are already discomforted either physically, mentally or socially require spending the shortest possible time in the hospital. The healthcare delivery system in the 21st century has undergone several changes due to the adoption of technology geared towards improving services. The OPD is no exception where technology has been adopted to reduce long queues. Despite the technology, several other contributions make up the OPD such as hospital staff working at the OPD, the patients and tailor-made protocols peculiar to hospitals. An increase in the waiting time subsequently reduces patients' satisfaction and therefore probing the factors that cause it is vital to providing quick and quality healthcare services. Therefore, the goal of this study is to investigate and elaborate on the factors that contribute to the increase in patient waiting time at the OPD. Current studies fail to focus on the several factors that contribute to the increase in waiting times but instead provide solutions that address one or a few factors. Our review, therefore, provided several solutions after identifying that staffing, demand, OPD Billing, the type of hospital, OPD layout and communication were among the several factors that increase patient waiting time in the OPD in the 21st century.


. Joustra, P. E., Kolfin, R., Van Dijk, N. M., Koning, C. C. E., & Bakker, P. J. M. (2012). Reduce fluctuations in capacity to improve the accessibility of radiotherapy treatment cost-effectively. Flex Serv Manuf J, 24, 448–464. https://doi.org/10.1007/s10696-011-9119-y

. A. Ikwunne, T., & O. Onyesolu, M. (2016). Optimality Test for Multi-Sever Queuing Model with Homogenous Server in the Out-Patient Department (OPD) of Nigeria Teaching Hospitals. International Journal of Modern Education and Computer Science, 8(4), 9–17. https://doi.org/10.5815/ijmecs.2016.04.02

. Afolabi, M. O., & Erhun, W. O. (2012). Patients’ response to waiting time in an out-patient pharmacy at a tertiary care hospital. Journal of Applied Pharmaceutical Science, 2(10), 090–093. https://doi.org/10.7324/JAPS.2012.21018

. Bleustein C, Rothschild DB, Valen A, et al.( 2014) Wait times, patient satisfaction scores, and the perception of care. The American Journal of Managed Care. May;20(5):393-400. PMID: 25181568.

. Adamu, H., & Oche, M. (2013). Determinants of patient waiting time in the general outpatient department of a tertiary health institution in North Western Nigeria. Annals of Medical and Health Sciences Research, 3(4), 588. https://doi.org/10.4103/2141-9248.122123

. Iloh, G., Njoku, P., Amadi, A., Godswill-Uko, E., Ofoedu, J., & Okafor, G. (2013). Satisfaction with Quality of Care Received by Patients without National Health Insurance Attending a Primary Care Clinic in a Resource-Poor Environment of a Tertiary Hospital in Eastern Nigeria in the Era of Scaling up the Nigerian Formal Sector Health In. Annals of Medical and Health Sciences Research, 3(1), 31. https://doi.org/10.4103/2141-9248.109471

. Kulkarni, S. D., Roshni, V., Varshitha, S., Sandeep, M. V., Monish, T., & Venkataraman, V. (2021). Modelling the patient flow in an out Patient Department (OPD) of a hospital using simulation techniques. IOP Conference Series: Materials Science and Engineering, 1059(1). https://doi.org/10.1088/1757-899X/1059/1/012041

. Ndukwe, H. C., Tayo, F., & Sariem, N. C. (2011). Factors Influencing Waiting Time in Outpatient Pharmacy of Lagos University Teaching Hospital. Research Journal of Pharmacy, 2(10), 2011. www.irjponline.com

. Wu, D., Cui, W., Wang, X., Huo, Y., Yu, G., & Chen, J. (2021). Improvement in outpatient services using the Wechat calling system in the Shanghai children’s hospital. Pakistan Journal of Medical Sciences, 37(4), 993–1000. https://doi.org/10.12669/pjms.37.4.4301

. Yaduvanshi, D., Sharma, A., & More, P. V. (2019). Application of Queuing Theory to Optimize Waiting-Time in Hospital Operations. OPERATIONS AND SUPPLY CHAIN MANAGEMENT, 12(3), 165–174.

. Fatma, F. P., & Basri, M. H. (2019). The analysis of appointment system to reduce outpatient waiting time at Trichy government hospital. Advances in Mathematics: Scientific Journal, 8(3 Special Issue), 276–284. https://doi.org/10.5923/j.hrmr.20130301.06

. Singh, A. K., & Khan, H. (2022). A study on waiting time of the OPD Patient in a Multispecialty Hospital. December 2021.

. Sun, J., Lin, Q., Zhao, P., Zhang, Q., Xu, K., Chen, H., Hu, C. J., Stuntz, M., Li, H., & Liu, Y. (2017b). Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study. BMC Public Health, 17(1). https://doi.org/10.1186/s12889-017-4667-z

. Green, L. (2006). Queuing analysis in healthcare, in Patient Flow: Reducing Delay in Healthcare Delivery. New York: Springer, 281–307. http://www.springerlink.com/index/t47q447l64651467.pdf

. MDA, K., KES, F., & DH, L. (2021). Factors Contributing to Increased Patient Waiting Time at Out Patient Department of Lady Ridgeway Hospital for Children in Sri Lanka and Strategies to Minimize the Waiting Time. International Journal Of Scientific Advances, 2(4), 475–478. https://doi.org/10.51542/ijscia.v2i4.2

. Omang, J., Ndep, A., Offiong, D., Otu, F., & Onyejose, K. (2020). Patient Waiting Time: A Public Health Perspective. 5(1), 4. www.ijisrt.com

. Guttmann, A., Schull, M. J., Vermeulen, M. J., & Stukel, T. A. (2011). Association between waiting times and short term mortality and hospital admission after departure from emergency department: Population based cohort study from Ontario, Canada. Bmj, 342(7809). https://doi.org/10.1136/bmj.d2983

. Michael, M., Schaffer, S. D., Egan, P. L., Little, B. B., & Pritchard, P. S. (2013). Improving wait times and patient satisfaction in primary care. Journal for Healthcare Quality?: Official Publication of the National Association for Healthcare Quality, 35(2), 50–60. https://doi.org/10.1111/jhq.12004

. frane, S., & Appah, A. (2014). Queuing theory and the management of Waiting-time in Hospitals: The case of Anglo Gold Ashanti Hospital in Ghana. International Journal of Academic Research in Business and Social Sciences, 4(2). https://doi.org/10.6007/ijarbss/v4-i2/590

. DeLia, D. (2007). Hospital Capacity, Patient Flow, and Emergency Department Use in New Jersey.

. McCarthy, S. M. (2010). Hospital capacity: what is the measure and what is the goal? MJA, 193(5), 252–253.

. Alhazzani, W., Møller, M. H., Arabi, Y. M., Loeb, M., Gong, M. N., Fan, E., Oczkowski, S., Levy, M. M., Derde, L., Dzierba, A., Aboodi, M., Wunsch, H., Cecconi, M., Koh, Y., Chertow, D. S., Maitland, K., Alshamsi, F., Belley-Cote, E., Greco, M., … Rhodes, A. (2020). Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Medicine, 46, 854–887. https://doi.org/10.1007/s00134-020-06022-5

. Pandey, N., Kaushal, V., Puri, G. D., Taneja, S., Biswal, M., Mahajan, P., Guru, R. R., Malhotra, P., Sehgal, I. S., Dhooria, S., Muthu, V., & Agarwal, R. (2020). Transforming a General Hospital to an Infectious Disease Hospital for COVID-19 Over 2 Weeks. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.00382

. Peiffer-Smadja, N., Lucet, J. C., Bendjelloul, G., Bouadma, L., Gerard, S., Choquet, C., Jacques, S., Khalil, A., Maisani, P., Casalino, E., Descamps, D., Timsit, J. F., Yazdanpanah, Y., & Lescure, F. X. (2020). Challenges and issues about organizing a hospital to respond to the COVID-19 outbreak: experience from a French reference centre. Clinical Microbiology and Infection, 26(6), 669–672. https://doi.org/10.1016/J.CMI.2020.04.002

. Anderson, R. T., Camacho, F. T., & Balkrishnan, R. (2007). Willing to wait? The influence of patient wait time on satisfaction with primary care. BMC Health Services Research, 7, 1–5. https://doi.org/10.1186/1472-6963-7-31

. Belayneh, M., Woldie, M., Berhanu, N., & Tamiru, M. (2017). The determinants of patient waiting time in the general outpatient department of Debre Markos and Felege Hiwot hospitals in Amhara regonal state,North West,Ethiopia. Global Journal of Medicine and Public Health, 6(5), 1–17.

. Motloba, P. D., Ncube, O., Makwakwa, L. N., & Machete, M. L. (2018). Patient waiting time and satisfaction at a Tertiary Dental School. South African Dental Journal, 73(6), 400–405. https://doi.org/10.17159/2519-0105/2018/v73no6a3

. Rajbhoj, S. (2022). Assessment of Out-Patient Waiting Time in a Dental Health Service of a Dental College?: A Cross Sectional Study. 207–210.

. Hemmati, F., Mahmoudi, G., Dabbaghi, F., Fatehi, F., & Rezazadeh, E. (2018). The factors affecting the waiting time of outpatients in the emergency unit of selected teaching hospitals of tehran. Electronic Journal of General Medicine, 15(4), 0–5. https://doi.org/10.29333/ejgm/93135

. Munavalli, J. R., Rao, S. V., Srinivasan, A., & Merode, F. Van. (2022). Dynamic Layout Design Optimization to Improve Patient Flow in Outpatient Clinics Using Genetic Algorithms.


. Sitepu, S., Mawengkang, H., & Husein, I. (2018). Optimization Model for Capacity Management and Bed Scheduling for Hospital Efficient Synthesis of Noble-Metal-Based Metallic Hydrogels/Aerogels and Their Electrochemical Applications Training strategy of CNN for remote sensing image classification with ac. The OSPAR Commission and Ministerial Meeting. https://doi.org/10.1088/1757-899X/300/1/012016

. Sæther, M. M. S., Heggestad, T., Heimdal, J., & Myrtveit, M. (2020). Long Waiting Times for Elective Hospital Care – Breaking the Vicious Circle by Abandoning Prioritisation. Kerman University of Medical Sciences, 9(3), 96–107. https://doi.org/10.15171/ijhpm.2019.84

. Ho, E. T. L. (2014). Improving waiting time and operational clinic flow in a tertiary diabetes center Emily. 1–5. https://doi.org/10.1136/bmjquality.u201918.w1006

. Habidin, N. F., Yahya, N. Z., & Ramil, M. F. S. (2015). Using LSS DMAIC in Improving Emergency Department Waiting Time. International Journal of Pharmaceutical Sciences Review and Research, 35(2)(December), 151–155.

. Egbujie, B. A., Grimwood, A., Mothibi-Wabafor, E. C., Fatti, G., Tshabalala, A. M. E. T., Allie, S., Vilakazi, G., & Oyebanji, O. (2018). Impact of ‘ideal clinic’ implementation on patient waiting time in primary healthcare clinics in Kwazulu-Natal province, South Africa: A before-and-after evaluation. South African Medical Journal, 108(4), 311–318. https://doi.org/10.7196/SAMJ.2018.v108i4.12583

. Tu, C., Nguyen, M., Nguyen, C., & Tu, M. (2017). Exploring the Association Between Patient Waiting Time, No-Shows and Overbooking Strategy to Improve E(ciency in Health Care Recommended Citation.

. Zeng, B., Zhao, H., & Lawley, M. (2009). Clinic Overbooking and Patient Responses: A Game Theoretical Approach. IIE Annual Conference. Proceedings, 785–790. http://search.proquest.com/docview/192457716?accountid=11077%5Cnhttp://sfxit.ugent.be/ugent?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&genre=article&sid=ProQ:ProQ%3Aabitrade&atitle=Clinic+Overbooking+and+Patient+Responses%3A+A+Game+Theor

. Mohebbifa, R., Hasanpoor, E., Mohseni, M., Sokhanvar, M., Khosravizadeh, O., & Mousavi Isfahani, H. (2014). Outpatient waiting time in health services and teaching hospitals: a case study in Iran. Global Journal of Health Science, 6(1), 172–180. https://doi.org/10.5539/gjhs.v6n1p172

. Al-Hanawi, M. K., Alsharqi, O., Almazrou, S., & Vaidya, K. (2018). Healthcare Finance in the Kingdom of Saudi Arabia: A Qualitative Study of Householders’ Attitudes. Applied Health Economics and Health Policy, 16(1), 55–64. https://doi.org/10.1007/s40258-017-0353-7

. Dalinjong, P. A., & Laar, A. S. (2012). Dalinjong-2012-The-national-health-insurance-schem.pdf. 1–13.

. Chen, B., Li, E., Kazunobu, Y., Ken, K., Shinji, N., & Miao, W. (2019). Impact of adjustment measures on reducing outpatient waiting time in a community: application of a computer simulation. Medical Association Publishing House, 35–44.

. Marwan, Y., Al-Saddique, M., Hassan, A., Karim, J., & Al-Saleh, M. (2012). Are medical students accepted by patients in teaching hospitals? Medical Education Online, 17(1). https://doi.org/10.3402/meo.v17i0.17172

. Ishijima, H., Eliakimu, E., & Mshana, J. M. (2015). The “ 5S ” approach to improve a working environment can reduce waiting time Findings from hospitals in Northern Tanzania. https://doi.org/10.1108/TQM-11-2014-0099

. Yulianto, W., Sujianto, S., & Hariyanti, T. (2021). Re-Layout of Service Room to Overcome Waiting Time of Finished Drug Services in Outpatient Pharmacy of dr . Iskak General Hospital Tulungagung Re-Layout ( italic ) Ruang Pelayanan?: Mengelola Waktu Tunggu Pelayanan Obat di Instalasi Farmasi Rawat Jalan RS. January, 568989.

. Levin, M. E. (2006). Language as a barrier to care for Xhosa-speaking patients at a South African paediatric teaching hospital. South African Medical Journal, 96(10), 1076–1079.

. Arendt, K. W., Sadosty, A. T., Weaver, A. L., Brent, C. R., & Boie, E. T. (2003). The left-without-being-seen patients: What would keep them from leaving? Annals of Emergency Medicine, 42(3), 317-IN2. https://doi.org/10.1016/S0196-0644(03)00404-9

. Kamran, M. A., & Karimi, B. (2020). AUT Jouranl of Modeling and Simulation Investigating and Analysis of Hospital Performance Using Discrete Event Simulation. AUT J. Model. Simul, 52(2), 203–214. https://doi.org/10.22060/miscj.2020.17697.5195

. Amarathunge, K. D. A. M., Amarathunge, J. A. Y. S., Anthony, F. S., & Arampath, A. M. T. . (2021). Patient Waiting Time , Consultation Time , and its effect on patient satisfaction at the Outpatient Department in Colombo North Teaching Hospital ( CNTH ). October. https://doi.org/10.13140/RG.2.2.36020.17287

. Naidoo, L., & Mahomed, O. H. (2021). Impact of Lean on patient cycle and waiting times at a rural district hospital in KwaZulu-Natal. African Journal of Primary Health Care and Family Medicine, 8(1), 1–9. https://doi.org/10.4102/phcfm.v8i1.1084


. harifi, S., & Saberi, K. (2014). CAPACITY PLANNING IN HOSPITAL MANAGEMENT: AN OVERVIEW. Indian Journal of Fundamental and Applied Life Sciences, 4(2). http://www.cibtech.org/jls.htm




How to Cite

Maame Fosua Afrifa-Minka, & Anubhav Sony. (2024). OPD Capacity in the 21st Century: A Review of the Factors that Increase Patient Waiting Time. International Journal of Natural Sciences: Current and Future Research Trends, 21(1), 1–16. Retrieved from https://ijnscfrtjournal.isrra.org/index.php/Natural_Sciences_Journal/article/view/1209