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Journal of the Academy of Hospital Administration

Profile of Patients Visiting Outpatient Department of a Large Teaching Hospital

Author(s): Reyaz Ahmad*, Syed Amin Tabish**, G J Qadiri***, Ajaz Mustaffa****

Vol. 13, No. 2 (2001-07 - 2001-12)

Abstract:

Key Messages:

  • Out patient services in a Teaching Hospital in Jammu and Kashmir are utilised by married adult males rural, literates, of poor socio economic status.
  • The patients in OPDs suffer mainly from diseases of the Gastrointestinal system, Cardiovascular system and Respiratory system.

Keywords :Outpatient Department, Teaching Hospital, Profile of Patients.

Introduction

Hospital is a phenomenon of 20th century. Its evolution of supporting sick from normal to care of sick and now it is sophistication of providing preventive, promotive, curative and rehabilitative services is phenomenal. As the hospital has grown in stature, so has its important arm, out-patient department. The activities of out-patient departments have made the hospital a real force in the community programme, for the prevention of diseases. Much of the investigations and diagnostic work that formerly necessitated admission to hospital wards can now be carried out in a well equipped out-patient department1.

The new concept "extended ambulatory services" is borne out of the fact that certain diseases are treated right in out-patient department, without getting patients admitted for long durations as inpatients, thus, reducing expenses for the patients, community and exchequer. Out-patient department services are corollary to inpatient services in the form of general out-patient department, day care, home-care and rehabilitative centres2.

It is important for planners to know about the catchment area of the hospital so that cost-effective and cost containment techniques will be employed before hospital gets commissioned. This is particularly true, when tremendous strides have been made as far as patients care through out-patient department is concerned.

Keeping in view a study was conducted for obtaining profile of patients attending Sher-e-Kashmir Institute of Medical Sciences (SKIMS) out-patient department.

Methodology

A questionnaire was administered to elicit information by subjecting a population of 400 patients to a number of questions, high lighting profile of patients. The sample population was selected in randomized fashion from Jan 1997 to August 1999. Patients were interviewed at the time of registration (before going for clinical consultation). Observations were made on different days of the week, selecting different timings for different days.

Observations

Profile of patients attending out-patient department

After subjecting 400 patients to questionnaire, following observations were made:

Frequency of variables

Age profile: 15(3.8%) were children, 61(15.3%) were adolescents, 274(68.5%) were adults, and 50(12.5%) were elderly. Distribution as per age in both sexes differs significantly (p<0.05) [Table-1].

Dwelling: >226(56.5%) were rural and 174 (43.5%) were urbanities. Distribution as per dwelling in both the sexes showed a significant difference (p<0.05) [Table -2}.

Literacy status: 118(29.5%) subjects were illiterate and 282 (70.5%) were literate. Distribution as per literary status in both sexes showed a significant difference (p<0.05) [Table-3].

Marital status:Out of 400 patients 266(66.5%) were married, whereas 134(33.5%) were unmarried. Distribution as per marital status in both the sexes does not show any significant difference (p>0.05).

Referrals: 12(3%) patients had referral letter from other hospitals (Kashmir), while 125 patients (31.3%) were referred from Primary Health Centre or Dispensary. 7 patients (1.8%) had referral from private clinics. 256 patients (64%) attended the out-patient department without any referral letter [Table-4].

Socioeconomic status: 96 Patients (24%) had average economic background, whereas 8 patients (2%) were rich and 296 patients (74%) were poor. Distribution as per socioeconomic status in both the sexes show a significant difference (p>0.05)[Table-5].

Sex: 173 patients (43.3%) were females and 227 patients (56.8%) were males.

Disease frequency

Fig. 1. Showing frequency of diseases

CNS = Central nervous system
CVD = Cardiovascular disorders
GE = Gastro-intestinal disorders
GUD = Genito-urinary disorders
MIS = Miscellaneous
MSD = Musculoskeletal disorders

Of the 400 patients, the frequency of disease was as under [Fig. 1]: "A"

Gastrointestinal disorders (GE) 124(31%)
Cardiovascular disorders(CVD) 58(14.5%)
Central nervous system disorders (CNS) 48(12.3%)
Musculoskeletal disorders (MSD) 44(11%)
Respiratory tract infections (RTI) 50(12.5%)
Genito-urinary disorders (GUD) 28(9.5%)
Miscellaneous disorders (MIS) 37(9.3%)

Frequency of assorted group of diseases

S.
No.
Miscellaneous disorder
Disease
Frequency
1. Mass right breast 7
2. Allergic skin eruptions 11
3. Submandibular abscess 5
4. Unexplained epistaxis 3
5. Pyrexia of unknown origin 2
6. Unexplained anemia 2
7. Lipoma 1
8. Wound infection 1
9. Post-craniotomy convulsions 1
10. Ophthalmic disorders 1
11. Alopecia areata 1
12. Post-menopausal syndrome 1
13. Blunt trauma chest 1
Total 37

Table 1. Frequency of age (N = 400)

Category Frequency Percent
Adolescent 61 15.3
Adult 274 68.5
Child 15 3.8
Elderly 50 12.5

Table 2. Frequency of dwelling (N = 400)

Frequency Percent
Rural 226 56.5
Urban 174 43.5

Table 3. Frequency of literary status (N = 400)

Literacy Status Frequency Percent
Illetrate 118 29.5
Literate 282 70.5

Table 4. Frequency of referrals

Referral Status Frequency Percent
Hospital 12 3.0
Non-referral 256 64.0
PHC Dis. 125 31.3
Pvt. Clinic 7 1.8

Table 5. Frequency of socioeconomic status (SES) (N = 400)

SE Status Frequency Percent
Average 96 24.0
Poor 296 74.0
Rich 8 2.0

Conclusion

Study has revealed out-patient department services are mostly utilized by adults (20-50 yrs), ruralites and literate. Patients visiting the area are predominantly poor, married and males. Affluent class usually attend private clinics. As rural health services in Kashmir valley are not in good shape, this is why services are utilized mostly by rural population. In one of the studies conducted in associated hospitals in Amritsar City, urbanities mostly utilize out-patient department services3. This is because primary health care is as such established in rural Punjab, unlike that of J and K. This fact is also corroborated by the finding that out of 400 patients only 125 (31.3%) patients were referred from PHC/rural dispensaries.

Among the study group of patients 31% have gestrointestinal problems. This is obvious, in view of peculiar food habits of people of Kashmir valley4.

As is evident from the study most of the patients are literate, which indicate high confidence level in the services.

References

  1. Sakharkar BM. Principles of hospital administration and planning; first edition (re-print) 1999; page 5.
  2. Alden B Mills. Functional planning of general hospitals. American Association of Hospital Consultants 1969; page 184.
  3. Mohan Virender, Pada AS, Deepti SS, Dhanjal Rajinder Singh, Mahajan Sham Lal, Lal Monohar: Level of patient satisfaction at the OPDs of hospital attached to Govt. Medical College, Amritsar, Punjab. Journal Academy of Hospital Administration 1999; 119(2): 29-35.
  4. Khuroo MS, Zargar SA, Mahajan R, Banday MA. High incidence of esophageal and gastric cancer in Kashmir in a population with special personal and dietary habits. Gut 1992; 33(1): 11-15.

* Sr. Resident, Department of Hospital Administration, S. K. Institute of Medical Sciences, Srinagar - 190011.
** Addl. Professor, Department of Hospital Administration, S. K. Institute of Medical Sciences, Srinagar - 190011.
*** Professor, Department of Hospital Administration, S. K. Institute of Medical Sciences, Srinagar - 190011.
**** Sr. Resident, Department of Hospital Administration, S. K. Institute of Medical Sciences, Srinagar - 190011.

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