4148.0: Tuesday, October 23, 2001 - 12:30 PM

Abstract #27225

Are health care providers overworked: Evidence from Jordan

Salah Mawajdeh, MD, DPh1, Sami Khoury, MD2, A.K. Nandakumar, PhD3, and Richard A. Yoder, PhD, MPH3. (1) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, (2) Faculty of Medicine, University of Jordan, Amman, Jordan, Jordan, (3) IHA, Abt Associates Inc, 55 Wheeler Street, Cambridge, MA 02138

Heavy patient loads is one of the more persistent problems identified by health providers in Jordan. As part of a larger "staffing and costing" study, an assessment was made of provider-patient contact time as well as provider time allocation patterns. Using stratified random sampling techniques, a sample of 101 primary care facilities in Jordan’s public sector was selected. From these facilities, a sample of 111 physicians, nurses and midwives was randomly selected. Average contact time and overall daily time allocation was derived using an adaptation of the recently developed “activity sampling technique.” The mean contact time per patient for physicians was 3’04” (minutes and seconds), midwives 5’56” and nurses 5’07.” Contact time was inversely related to volume of visits (patients per provider) with mean contact time being 3’12” at high volume facilities, 3’55” at medium volume facilities, and 4’57” at low volume facilities. In terms of how staff time was allocated, an average of 33 percent of their combined time was spent on clinical activities, 14 percent on non-clinical activities, and 53 percent downtime. By volume of visits, 20 percent of staff time at low volume facilities was spent on clinical activities, 28 percent on non-clinical activities, and 52 percent on downtime. At high volume facilities, 34 percent of time was for clinical activities, 21 percent for non-clinical activities, and 45 percent was downtime. Implications of these findings, all of which were significant at p=.05, for rationalizing staffing patterns are discussed.

Learning Objectives: At the conclusion of this session, participants will be able to (1) compare provider-patient contact time among physicians, nurses and midwives in high to low patient volume clinics, and (2) assess time allocation patterns of providers among clinical, non-clinical and downtime activities in high to low volume clinics.

Keywords: Health Reform, Service Delivery

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA