Effects of appointment scheduling on waiting time and utilisation of antenatal care in Mozambique
Background Poor patient experience, including long waiting time, is a potential reason for low healthcare utilisation. In this study, we evaluate the impact of appointment scheduling on waiting time and utilisation of antenatal care.Methods We implemented a pilot study in Mozambique introducing appo...
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BMJ Publishing Group
2019-12-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/4/6/e001788.full |
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| author | Margaret McConnell Maria Steenland Janeth Dula Amanda de Albuquerque Quinhas Fernandes Rosa Marlene Cuco Sergio Chicumbe Eduardo Samo Gudo Sandra Sequeira |
| author_facet | Margaret McConnell Maria Steenland Janeth Dula Amanda de Albuquerque Quinhas Fernandes Rosa Marlene Cuco Sergio Chicumbe Eduardo Samo Gudo Sandra Sequeira |
| author_sort | Margaret McConnell |
| collection | DOAJ |
| description | Background Poor patient experience, including long waiting time, is a potential reason for low healthcare utilisation. In this study, we evaluate the impact of appointment scheduling on waiting time and utilisation of antenatal care.Methods We implemented a pilot study in Mozambique introducing appointment scheduling to three maternity clinics, with a fourth facility used as a comparison. The intervention provided women with a return date and time for their next antenatal care visit. Waiting times and antenatal care utilisation data were collected in all study facilities. We assessed the effect of changing from first come, first served to scheduled antenatal care visits on waiting time and complete antenatal care (≥4 visits during pregnancy). Our primary analysis compared treatment facilities over time; in addition, we compared the treatment and comparison facilities using difference in differences.Results We collected waiting time data for antenatal care from 6918 women, and antenatal care attendance over the course of pregnancy from 8385 women. Scheduling appointments reduced waiting time for antenatal care in treatment facilities by 100 min (95% CI −107.2 to -92.9) compared with baseline. Using administrative records, we found that exposure to the scheduling intervention during pregnancy was associated with an approximately 16 percentage point increase in receipt of four or more antenatal care visits during pregnancy.Conclusions Relatively simple improvements in the organisation of care that reduce waiting time may increase utilisation of healthcare during pregnancy. A larger scale study is needed to provide information about whether appointment scheduling can be sustained over time.Trial registration number NCT02938936. |
| format | Article |
| id | doaj-art-b0d1f64072784b40b923725a2ca3124d |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Global Health |
| spelling | doaj-art-b0d1f64072784b40b923725a2ca3124d2024-12-12T03:15:07ZengBMJ Publishing GroupBMJ Global Health2059-79082019-12-014610.1136/bmjgh-2019-001788Effects of appointment scheduling on waiting time and utilisation of antenatal care in MozambiqueMargaret McConnell0Maria Steenland1Janeth Dula2Amanda de Albuquerque3Quinhas Fernandes4Rosa Marlene Cuco5Sergio Chicumbe6Eduardo Samo Gudo7Sandra Sequeira8Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USAPopulation Studies and Training Center, Brown University, Providence, Rhode Island, USAInstituto Nacional de Saúde, Ministério da Saúde, Maputo, MozambiquePontifical Catholic University of Rio de Janeiro, Rio de Janeiro, BrazilDepartment of Global Health, University of Washington, Seattle, Washington, USANational Directorate of Public Health, Ministry of Health, Maputo, MozambiqueInstituto Nacional de Saúde (INS), Distrito de Marracuene, Estrada Nacional N°1, Maputo, MozambiqueInstituto Nacional de Saúde, Ministério da Saúde, Maputo, MozambiqueDepartment of International Development, London School of Economics, London, UKBackground Poor patient experience, including long waiting time, is a potential reason for low healthcare utilisation. In this study, we evaluate the impact of appointment scheduling on waiting time and utilisation of antenatal care.Methods We implemented a pilot study in Mozambique introducing appointment scheduling to three maternity clinics, with a fourth facility used as a comparison. The intervention provided women with a return date and time for their next antenatal care visit. Waiting times and antenatal care utilisation data were collected in all study facilities. We assessed the effect of changing from first come, first served to scheduled antenatal care visits on waiting time and complete antenatal care (≥4 visits during pregnancy). Our primary analysis compared treatment facilities over time; in addition, we compared the treatment and comparison facilities using difference in differences.Results We collected waiting time data for antenatal care from 6918 women, and antenatal care attendance over the course of pregnancy from 8385 women. Scheduling appointments reduced waiting time for antenatal care in treatment facilities by 100 min (95% CI −107.2 to -92.9) compared with baseline. Using administrative records, we found that exposure to the scheduling intervention during pregnancy was associated with an approximately 16 percentage point increase in receipt of four or more antenatal care visits during pregnancy.Conclusions Relatively simple improvements in the organisation of care that reduce waiting time may increase utilisation of healthcare during pregnancy. A larger scale study is needed to provide information about whether appointment scheduling can be sustained over time.Trial registration number NCT02938936.https://gh.bmj.com/content/4/6/e001788.full |
| spellingShingle | Margaret McConnell Maria Steenland Janeth Dula Amanda de Albuquerque Quinhas Fernandes Rosa Marlene Cuco Sergio Chicumbe Eduardo Samo Gudo Sandra Sequeira Effects of appointment scheduling on waiting time and utilisation of antenatal care in Mozambique BMJ Global Health |
| title | Effects of appointment scheduling on waiting time and utilisation of antenatal care in Mozambique |
| title_full | Effects of appointment scheduling on waiting time and utilisation of antenatal care in Mozambique |
| title_fullStr | Effects of appointment scheduling on waiting time and utilisation of antenatal care in Mozambique |
| title_full_unstemmed | Effects of appointment scheduling on waiting time and utilisation of antenatal care in Mozambique |
| title_short | Effects of appointment scheduling on waiting time and utilisation of antenatal care in Mozambique |
| title_sort | effects of appointment scheduling on waiting time and utilisation of antenatal care in mozambique |
| url | https://gh.bmj.com/content/4/6/e001788.full |
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