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dc.contributoreditor: Kiggundu, Reuben
dc.contributor.authorKarat, Aaron S.
dc.contributor.authorMcCreesh, Nicky
dc.contributor.authorBaisley, Kathy
dc.contributor.authorGovender, Indira
dc.contributor.authorKallon, Idriss I.
dc.contributor.authorKielmann, Karina
dc.contributor.authorMacGregor, Hayley
dc.contributor.authorVassall, Anna
dc.contributor.authorYates, Tom A.
dc.contributor.authorGrant, Alison D.
dc.date.accessioned2022-07-21T07:47:09Z
dc.date.available2022-07-21T07:47:09Z
dc.date.issued2022-07-20
dc.date.submitted2021-09-01
dc.identifierdoi: 10.1371/journal.pgph.0000684
dc.identifierpublisher-id: pgph-d-21-00590
dc.identifier.citationPLOS Global Public Health, volume 2, issue 7, article-number e0000684
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/12539
dc.descriptionFrom PLOS via Jisc Publications Router
dc.descriptionHistory: received 2021-09-01, collection 2022, accepted 2022-06-13, epub 2022-07-20
dc.descriptionPublication status: Published
dc.descriptionFunder: Economic and Social Research Council; funder-id: http://dx.doi.org/10.13039/501100000269; Grant(s): ES/P008011/1
dc.descriptionFunder: The Bloomsbury SET; Grant(s): CCF17-7779
dc.description.abstractTransmission of respiratory pathogens, such as Mycobacterium tuberculosis and severe acute respiratory syndrome coronavirus 2, is more likely during close, prolonged contact and when sharing a poorly ventilated space. Reducing overcrowding of health facilities is a recognised infection prevention and control (IPC) strategy; reliable estimates of waiting times and ‘patient flow’ would help guide implementation. As part of the Umoya omuhle study, we aimed to estimate clinic visit duration, time spent indoors versus outdoors, and occupancy density of waiting rooms in clinics in KwaZulu-Natal (KZN) and Western Cape (WC), South Africa. We used unique barcodes to track attendees’ movements in 11 clinics, multiple imputation to estimate missing arrival and departure times, and mixed-effects linear regression to examine associations with visit duration. 2,903 attendees were included. Median visit duration was 2 hours 36 minutes (interquartile range [IQR] 01:36–3:43). Longer mean visit times were associated with being female (13.5 minutes longer than males; p<0.001) and attending with a baby (18.8 minutes longer than those without; p<0.01), and shorter mean times with later arrival (14.9 minutes shorter per hour after 0700; p<0.001). Overall, attendees spent more of their time indoors (median 95.6% [IQR 46–100]) than outdoors (2.5% [IQR 0–35]). Attendees at clinics with outdoor waiting areas spent a greater proportion (median 13.7% [IQR 1–75]) of their time outdoors. In two clinics in KZN (no appointment system), occupancy densities of ~2.0 persons/m2 were observed in smaller waiting rooms during busy periods. In one clinic in WC (appointment system, larger waiting areas), occupancy density did not exceed 1.0 persons/m2 despite higher overall attendance. In this study, longer waiting times were associated with early arrival, being female, and attending with a young child. Occupancy of waiting rooms varied substantially between rooms and over the clinic day. Light-touch estimation of occupancy density may help guide interventions to improve patient flow.
dc.languageen
dc.publisherPublic Library of Science
dc.rightsLicence for this article: http://creativecommons.org/licenses/by/4.0/
dc.sourceeissn: 2767-3375
dc.subjectResearch Article
dc.subjectMedicine and health sciences
dc.subjectComputer and information sciences
dc.subjectPeople and places
dc.subjectBiology and life sciences
dc.titleEstimating waiting times, patient flow, and waiting room occupancy density as part of tuberculosis infection prevention and control research in South African primary health care clinics
dc.typearticle
dcterms.dateAccepted2022-06-13
dc.date.updated2022-07-20T19:00:13Z


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