Audit Reveals Long Waiting Times and Short Consultations in J&K Health Facilities
New Delhi: A recent audit report by the Comptroller and Auditor General (CAG) of India has brought to light significant issues concerning the functioning of outpatient departments (OPDs) in government health institutions across Jammu and Kashmir. The report flags prolonged patient waiting periods, an uneven distribution of doctor workload, and critically short consultation durations as key areas needing urgent attention.
The Chenab Times has learned that the CAG’s performance audit on Public Health Infrastructure and Management of Health Services, covering the period up to March 2022, examined OPD operations between 2016 and 2022. The findings indicate substantial disparities in the number of patients attended to by doctors across various healthcare facilities, suggesting imbalances in staffing levels and the allocation of patient load.
The audit report highlighted instances of extreme variations in patient numbers handled by individual doctors annually. For example, at the Sub-District Hospital Bijbehara, a single doctor managed an average of 49,892 OPD cases per year. In contrast, the Sub-District Hospital Jagti saw a much lower figure of 2,389 cases per doctor annually. This wide disparity underscores an uneven distribution of work and points to potential inefficiencies in staff deployment.
According to the CAG, the number of OPD cases per doctor per day serves as a crucial indicator of operational efficiency. The observed variations suggest a mismatch between patient influx and the availability of medical personnel, emphasizing the necessity for a more rational approach to the creation and deployment of medical posts within the Union Territory.
Furthermore, the audit report drew attention to the persistently low consultation times afforded to patients across the surveyed health institutions. Between 2016 and 2022, in tertiary hospitals, a significant number of patients were examined for durations shorter than five minutes. Specifically, 59.69 lakh patients received consultations lasting less than five minutes, while 73.35 lakh patients were attended to for five to ten minutes. Only 11.22 lakh patients were granted consultations exceeding ten minutes.
Similar trends were observed in district hospitals, where 65.24 lakh patients were seen for less than five minutes, and 29.06 lakh for five to ten minutes. A considerably smaller segment, 3.71 lakh patients, received consultations longer than ten minutes. In sub-district hospitals and community health centres, the situation was marginally better, with 55.81 lakh patients examined in under five minutes, 52.32 lakh in five to ten minutes, and 37.86 lakh in over ten minutes.
Overall, the audit data revealed that approximately 58 per cent of all patients examined across these facilities received consultation times of less than five minutes. Fewer than two per cent of patients reported having consultations that extended beyond 15 minutes, indicating a systemic issue impacting the depth of patient-doctor interaction.
To gauge patient waiting times, the CAG conducted a survey involving 750 outpatients across tertiary, district, sub-district hospitals, and community health centres. The findings indicated delays at various stages of the patient journey within the healthcare system. For registration alone, 325 patients, or 43 per cent, were registered within five minutes. However, 141 patients took between six and ten minutes, 115 took between 11 and 15 minutes, and a substantial 169 patients waited for more than 15 minutes to complete the registration process.
The registration times also varied significantly by hospital type. In tertiary hospitals, only 17 patients were registered within five minutes, whereas 157 patients were registered within the same timeframe in community health centres. Conversely, 66 patients in tertiary hospitals and 46 in district hospitals experienced registration delays exceeding 15 minutes. The report noted that 34 per cent of patients in tertiary and district hospitals faced registration waits of over 15 minutes.
The waiting period between registration and the actual doctor consultation also emerged as a concern. While 357 patients were attended to within 15 minutes of registration, 196 patients waited between 16 and 30 minutes, 145 waited between 31 and 60 minutes, and 52 patients endured waits exceeding an hour.
Within tertiary hospitals specifically, 90 patients waited between 31 and 60 minutes for their consultation, with an additional 41 patients waiting for over an hour. The audit observed that approximately 62 per cent of patients in tertiary hospitals waited more than 30 minutes for a doctor’s consultation. For district, sub-district hospitals, and community health centres, about 40 per cent of patients experienced waits longer than 15 minutes post-registration.
Regarding consultation duration in the surveyed sample, the report indicated that 436 patients were examined for up to five minutes, 262 for six to ten minutes, 39 for 11 to 15 minutes, and only 13 patients for durations exceeding 15 minutes. The CAG concluded that the combination of extensive waiting times and brief consultation periods reflects systemic pressures on public health institutions. The varied OPD workloads further indicate an imbalance between doctor availability and patient demand. The report recommended aligning staffing levels with patient loads and utilizing such analyses to guide the creation and deployment of medical posts to enhance the efficiency and quality of care in Jammu and Kashmir’s outpatient departments.
The Chenab Times News Desk