Hui Zhang

Background: Long waiting time in hospital leads to patient’s low satisfaction. In addition to reducing the actual waiting time (AWT), we can also improve satisfaction by adjusting the expected waiting time (EWT). Then how much can the EWT be adjusted to attribute a higher satisfaction?Methods: This study was conducted though experimental with hypothetical scenarios. A total of 303 patients who were treated by the same doctor from August 2021 to April 2022 voluntarily participated in this study. The patients were randomly divided into six groups: a control group (n = 52) and five experimental groups (n = 245). In the control group, the patients were asked their satisfaction degree regarding a communicated EWT (T₀) and AWT (T_a) under a hypothetical situation. In the experimental groups, in addition to the same T₀and T_aas the control group, the patients were also asked about their satisfaction degree with the extended communicated EWT (T₁). Patients in five experimental groups were given T₁values with 70, 80, 90, 100, and 110 min respectively. Patients in both control and experiment groups were asked to indicate their initial EWT, after given unfavorable information (UI) in a hypothetical situation, the experiment groups were asked to indicate their extended EWT. Each participant only participated in filling out one hypothetical scenario. 297 valid hypothetical scenarios were obtained from the 303 hypothetical scenarios given.Results: The experimental groups had significant differences between the initial indicated EWT and extended indicated EWT under the effect of UI (20 [10, 30] vs. 30 [10, 50],Z= -4.086,P < 0.001). There was no significant difference in gender, age, education level and hospital visit history (χ² = 3.198,P = 0.270;χ² = 2.177,P = 0.903;χ² = 3.988,P = 0.678;χ² = 3.979,P = 0.264) in extended indicated EWT. As for patient’s satisfaction, compared with the control group, significant differences were found when T₁ = 80 min (χ² = 13.511,P = 0.004), T₁ = 90 min (χ² = 12.207,P = 0.007) and T₁ = 100 min (χ² = 12.941,P = 0.005). When T₁ = 90 min, which is equal to the T_a, 69.4% (34/49) of the patients felt “very satisfied”, this proportion is not only significantly higher than that of the control group (34/ 49 vs. 19/52,χ² = 10.916,P = 0.001), but also the highest among all groups. When T₁ = 100 min (10 min longer than T_a), 62.5% (30/48) of the patients felt “very satisfied”, it is significantly higher than that of the control group (30/ 48 vs. 19/52,χ² = 6.732,P = 0.009). When T₁ = 80 min (10 min shorter than T_a), 64.8% (35/54) of the patients felt “satisfied”, it is significantly higher than that of the control group (35/ 54 vs. 17/52,χ² = 10.938,P = 0.001). However, no significant difference was found when T₁ = 70 min (χ² = 7.747,P = 0.052) and T₁ = 110 min (χ² = 4.382,P = 0.223).Conclusions: Providing UI prompts can extend the EWT. When the extended EWT is closer to the AWT, the patient’s satisfaction level can be improved higher. Therefore, medical institutions can adjust the EWT of patient’s through UI release according to the AWT of hospitals to improve patient’s satisfaction.

Long waiting times result in low satisfaction. Although several methods are used to shorten the actual waiting time (AWT) in large hospitals of China, the outpatients still have a long actual waiting time. This study aimed to explore whether satisfaction could be improved by extending the expected waiting time (EWT) instead of shortening the AWT. In October 2016, 257 students in grade one voluntarily participated in this study. They came from 6 classes, which were randomly divided into two groups: 3 classes comprised the control group (n = 125) and 3 classes comprised the experimental group (n = 132). Unfavorable information (UI) was given to the experimental group alone. Six distinct questionnaires were designed to explore the effects of UI on EWT and the effects of an extended EWT on satisfaction. Satisfaction scores ranged from 0 to 100: 0–25, very dissatisfied; 26–50, dissatisfied; 51–75, satisfied; 76–100, very satisfied. Each participant finished one of the 6 questionnaires online. Of the 257 questionnaires, 233 were valid. Before UI was given, the initial EWT (T0) was similar between the control and experimental groups (Z = -1.924, P = 0.054). Under the effects of UI, individuals in the experimental group extended their EWT (T1) from 121.0 to 180.0 min (Z = -6.367, P < 0.001). Females prolonged their EWT longer than males did (Z = -2.239, P = 0.025). Then, this study defined T0 = 1.5 h and T1 = 2.5 h, and compared the satisfaction scores between the control and experimental groups: a significant difference was found when AWT =2.0 h (t = − 3.568, P = 0.001), but not when AWT =3.0 h (t = − 0.718, P = 0.475) or when AWT =1.0 h (t = − 1.088, P = 0.280). When AWT =3.0 h, fewer individuals felt “very dissatisfied” in the experimental group (21.2%) than in the control group (44.7%) (χ2 = 4.368, P = 0.037). EWT was found to be extended greatly by UI. An extended EWT could improve satisfaction scores.

Individuals’ decision‐making depends on reference points in prospect theory. This research considers the bounded rationality of decision makers and constructs a dynamic hybrid multiple attribute decision‐making (DHMADM) model. Unlike existing models, the DHMADM model focuses on dynamic reference point, which has been proven in prospect theory. This research presents the effects of reference point adaptation on decision‐making through model calculation. The optimal choice of decision makers changed with the change of the reference point in the DHMADM model. By experiment, we found that the DHMADM model considering reference point adaptation can more accurately express the final choice of decision makers than models only considering the static reference point.