Waiting Time Management and Outpatient Satisfaction: A Systematic Literature Review

Abstract

Patient satisfaction is an important indicator of hospital service quality. In outpatient care, waiting time is one of the most tangible aspects experienced by patients and reflects the effectiveness of service processes, resource management, capacity, and information systems. This study aimed to systematically analyze evidence regarding the relationship between waiting time and outpatient patient satisfaction, identify service quality dimensions associated with waiting experiences, and formulate improvement strategies relevant to hospital management. A Systematic Literature Review (SLR) was conducted following the PRISMA 2020 guidelines. Literature was searched through scientific databases and official sources using the keywords outpatient waiting time, patient satisfaction, service quality, SERVQUAL, and healthcare process improvement. The review focused on publications from 2020 to 2026, with eligible studies identified based on predefined inclusion and exclusion criteria. A total of 10 studies published between 2021 and 2026 were included in the final synthesis. The eligible studies were analyzed narratively and thematically based on study characteristics, waiting time, determinants of satisfaction, service quality dimensions, and improvement interventions. The literature indicates a complex relationship between waiting time and patient satisfaction. Although prolonged actual waiting time may reduce satisfaction, patients' perceptions, expectations, tolerance, and the discrepancy between expected and experienced waiting time also play important roles. Responsiveness and reliability consistently emerged as key service quality dimensions associated with waiting experiences, while assurance, empathy, and tangibles also contributed to overall perceptions of service quality. Interventions including appointment-based scheduling, workflow optimization, Lean Healthcare, electronic medical records, digital registration, and queue management have the potential to reduce waiting time when implemented as integrated strategies. Waiting time represents both an operational indicator and an important component of patient experience. Effective management requires a systemic approach integrating process redesign, capacity management, patient communication, digitalization, and continuous quality monitoring.