The Impact of Long Waiting Times on Patient Trust and Satisfaction in Public-Sector Primary Healthcare Facilities: A Scoping Review
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Abstract
Background. Long waiting times are among the most visible and most frequently reported problems in public-sector primary healthcare. Patients wait to register, to see a clinician, and to receive tests and medicines. Waiting is often assumed to reduce patient satisfaction and to erode trust in the health system, but the evidence on these two outcomes has not been mapped together, and trust in particular is studied far less than satisfaction.
Objective. To map what is known about (1) how waiting time relates to patient satisfaction and patient trust in public-sector primary care, (2) which factors lie behind long waiting times, and (3) which interventions have been tested, and to identify gaps for future research.
Methods. A scoping review guided by the Arksey and O’Malley framework, its later refinements, and the PRISMA-ScR reporting checklist. The Population-Concept-Context framework was used: patients using public-sector primary care (population); waiting time and its relationship to satisfaction or trust (concept); public primary healthcare facilities in any country (context). This version reports a targeted search of open-access sources. Sources that could be read in full were charted; sources identified but not accessible in full are listed separately and are not used for numerical claims. A full multi-database search strategy is provided so the review can be completed to registered scoping-review standard.
Results. [Insert final counts after the full search; see Section 4.1.] In the sources charted here, three patterns emerge. First, waiting time is consistently described as a problem in public facilities, and is statistically associated with satisfaction in at least one large Pakistani outpatient survey (850 respondents). Second, trust is conceptualised as a multidimensional construct (for example, eight dimensions in a Lao study) in which respectful, responsive care matters more than technical competence alone; qualitative work in Zambian primary health centres shows that repeated experiences of unresponsive care can undermine trust even where patients believe staff are clinically capable. Third, a systematic review of 11 studies of interventions to cut appointment wait times found reductions averaging 11.3 days, but satisfaction improved in only one of the three studies that measured it. No source charted here directly tested the pathway from waiting time to trust.
Conclusions. The link between waiting and satisfaction is plausible and partly supported, but the link between waiting and trust is largely inferred rather than measured. Future studies should measure actual and perceived waiting time together with validated trust scales in public primary care, and evaluate waiting-time interventions against trust as well as satisfaction.
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References
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