Patient Satisfaction and Waiting Time in General Outpatient Departments of State and Federal Teaching Hospitals in Enugu State, Nigeria: A Comparative Mixed-Methods Study

Patient satisfaction reflects how well patients perceive healthcare services meet their needs and expectations and is widely used as an indicator of quality of care. It is shaped by clinical and non-clinical factors, including staff attitude and communication, facility organization, costs, and waiting time. This study assessed and compared patient satisfaction and waiting time in the General Outpatient Departments (GOPDs) of a state and a federal teaching hospital in Enugu State, Nigeria. A comparative mixed-methods design was used at the GOPDs of the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, and the Enugu State University of Science and Technology Teaching Hospital, Parklane (ESUTTHP). Quantitative data were collected using a structured 5-point Likert-scale questionnaire and a patient time-tracking schedule across service points (payment, registration, waiting area, nurses’ station, and consulting room). Sample size was determined using the WHO national guideline for sample size determination in health studies, and 188 first-time adult patients (≥18 years) were recruited (UNTH n=108; ESUTTHP n=80). Six participants were purposively selected for in-depth interviews. Descriptive statistics were used to summarize variables, and differences between hospitals were tested at α=0.05 using GraphPad Prism v7.5. Overall, 188 participants were analyzed; 59.0% were female and the mean age was 53 years (range: 18–88). Total waiting time was 227.21 minutes in ESUTTHP and 234.00 minutes in UNTH. Mean waiting times across service stations ranged from 26.46-58.29 minutes in ESUTTHP and 9.25–121.05 minutes in UNTH, with the longest delays occurring at payment and registration in UNTH. Most respondents reported satisfaction with waiting time and service delivery in both hospitals, but satisfaction differed significantly between ESUTTHP and UNTH (p<0.0001). Qualitative findings supported the quantitative results and pointed to queue control, staff communication, and costs as key drivers of satisfaction and dissatisfaction. In conclusion, patients reported generally high satisfaction with GOPD services in both teaching hospitals, although satisfaction levels differed significantly between the state and federal facilities. Strengthening administrative processes especially payment and registration improving communication about delays, and enhancing cost transparency may further improve patient experience. Keywords: patient satisfaction; outpatient services; waiting time; healthcare quality; communication; teaching hospitals; Enugu State; Nigeria.