Risk Analysis of Outpatient Waiting Times: The Impact of Technology-Based vs. Manual Queuing Systems in East Java Hospitals

Anif Prasetyorini; Eka Wilda Faida; Achmad Djunawan; Serlly Frida  Drastyana

doi:10.56741/IISTR.jphs.002017

Authors

Anif Prasetyorini
anifrini@gmail.com
STIKES Yayasan RS Dr. Soetomo https://orcid.org/0000-0003-1130-7326
Eka Wilda Faida STIKES Yayasan RS Dr. Soetomo https://orcid.org/0000-0002-6460-1740
Achmad Djunawan STIKES Yayasan RS Dr. Soetomo https://orcid.org/0000-0003-1594-3397
Serlly Frida Drastyana STIKES Yayasan RS Dr. Soetomo https://orcid.org/0000-0003-2377-7624

Keywords:

Hospital Risk Level, Queuing System, Technology-Based, Waiting Time

Abstract

In Indonesian hospitals, prolonged waiting times for outpatient services remain a critical challenge, particularly in facilities lacking integrated queue management technology. This study evaluates the variation in waiting time risks between hospitals utilizing traditional manual systems and those employing partially connected digital systems. Using a purposive sampling method, we assessed ten hospitals, comprising both public and private institutions. Crucially, we implemented the Risk Grading Matrix as a novel analytical framework to evaluate risk levels by quantifying the likelihood and clinical impact of service delays in every hospital. Our analysis revealed that all participating hospitals exceeded the national waiting time standard of 60 minutes. However, the risk assessment demonstrated distinct differences based on system integration. Hospitals with less advanced, partially connected digital systems exhibited significantly higher risk profiles compared to those relying on manual systems (total risk score: p=.008). Furthermore, both the likelihood of delays (p=.031) and the severity of impact on patient safety (p=.017) were statistically higher in facilities with inefficient digital integration. These findings indicate that the architecture of a queue management system is a primary determinant of waiting time risks, which directly undermines patient satisfaction and timely care delivery. Consequently, we advocate for the adoption of optimized digital queue management systems, as they provide a more robust approach to enhancing service quality, patient safety, and institutional risk governance.

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Author Biographies

Anif Prasetyorini, STIKES Yayasan RS Dr. Soetomo

is a lecturer at STIKES Yayasan RS Dr. Soetomo, Surabaya, affiliated with the Hospital Administration program. Her academic work covers public health, hospital management, health policy, organizational collaboration, service management, and healthcare financing. She is also active as a researcher, book author, journal reviewer, consultant, and resource person in hospital-administration development nationally. (email: anifrini@gmail.com).

Eka Wilda Faida, STIKES Yayasan RS Dr. Soetomo

is a lecturer in the Medical Records and Health Information program at STIKES Yayasan RS Dr. Soetomo, Surabaya. Her research focuses on health management, medical records, electronic medical records, health information systems, organizational management, and technology adoption. She also writes academic books and contributes actively as a researcher, reviewer, and educator. (email: ekawildafaida@gmail.com).

Achmad Djunawan, STIKES Yayasan RS Dr. Soetomo

is a lecturer in the Hospital Administration program at STIKES Yayasan RS Dr. Soetomo, Surabaya. His scholarly interests include public health, health policy, health management, health insurance, hospital workforce management, employee well-being, and retention. He publishes research, writes academic books, reviews journal manuscripts, and participates in community-service initiatives related to healthcare administration and management. (email: achmadjuna@gmail.com).

Serlly Frida Drastyana, STIKES Yayasan RS Dr. Soetomo

is a senior lecturer in the Hospital Administration program at STIKES Yayasan RS Dr. Soetomo, Surabaya, where she holds the functional rank of Lektor. Her research addresses environmental health, hospital environmental management, air quality, occupational health, waste management, and geographic information systems. She is also active in research, book writing, and community service. (email: serlly.frida@gmail.com).

References

D. A. R. Pratiwi, “Analisis Penggunaan Sistem Antrian Di Rumah Sakit Dari Perspektif Penyedia Dan Pelanggan : Literature Review,” Jurnal Kesehatan Tambusai, vol. 6, no. 1, pp. 286–297, 2025.

S. U. Huvaid, N. Adhyka, and E. Antika, “Analisis Waktu Tunggu Pelayanan di Instalasi Farmasi Pada Pasien Rawat Jalan di RSI Siti Rahmah,” Jurnal Kedokteran dan Kesehatan, vol. 19, no. 2, pp. 165–172, Jul. 2023, [Online]. Available: https://jurnal.umj.ac.id/index.php/JKK

N. Nabila and D. Ayuningtyas, “A Systematic Review of Complication Rates in Elderly Age Patients Undergoing Knee Arthroplasty: The Effectiveness of Outpatient Waiting Time in Hospital through Online or Web-based Reservation (Literature Review),” Asian Journal of Engineering, Social and Health, vol. 3, no. 8, pp. 1725–1739, 2024, [Online]. Available: https://ajesh.ph/index.php/gp

H. Susilo, M. Ihksan, N. Abdillah, and D. Fauzi, “Transformation of Patient Queuing System at Medika Saintika Clinic based on Web,” Journal of Medical Record and Information Technology (JOMRIT), vol. 2, no. 1, pp. 17–24, Jun. 2024.

M. Tran and T. Nguyen, “A Comparative Study of Manual Versus Automated Claims Processing Systems in Healthcare: Impacts on Accuracy, Cost, and Patient Satisfaction,” Transdisciplinary Advances in Social Computing, Complex Dynamics, and Computational Creativity, vol. 15, no. 5, pp. 1–12, 2025.

T. Kropp, S. Faeghi, and K. Lennerts, “Evaluation of patient transport service in hospitals using process mining methods: Patients’ perspective,” International Journal of Health Planning and Management, vol. 38, no. 2, pp. 430–456, Mar. 2023, doi: 10.1002/hpm.3593.

E. M. Shbaily et al., “Effectiveness of Pharmacy Automation Systems Versus Traditional Systems in Hospital Settings: A Systematic Review,” Cureus, Jan. 2025, doi: 10.7759/cureus.77934.

A. H. Elmi and F. Y. Yusuf, “Understanding The Global Public Health Impact of Long COVID And Strategies For Sustainable Care,” Discover Public Health, vol. 23, no. 43, pp. 1–14, Jan. 2026, doi: 10.1186/s12982-026-01372-9.

D. M. Limiri, “The Impact of Long Wait Times on Patient Health Outcomes: The Growing NHS Crisis,” Premier Journal of Public Health, Feb. 2025, doi: 10.70389/PJPH.100020.

P. Åhlin, P. Almström, and C. Wänström, “Solutions for improved hospital-wide patient flows – a qualitative interview study of leading healthcare providers,” BMC Health Serv. Res., vol. 23, no. 17, pp. 1–17, Dec. 2023, doi: 10.1186/s12913-022-09015-w.

M. Alfaqeeh, N. Zakiyah, M. J. Postma, and A. A. Suwantika, “Setting Priorities For Healthcare Interventions in Indonesia: a Comprehensive Conceptual Framework,” Int. J. Equity Health, vol. 24, no. 327, pp. 1–22, Dec. 2025, doi: 10.1186/s12939-025-02668-z.

P. Herd and D. Moynihan, “Administrative Burdens in the Social Safety Net,” in Journal of Economic Perspectives, American Economic Association, Dec. 2025, pp. 129–149. doi: 10.1257/jep.20231394.

F. Fina Setiyawati, A. Kurnianto, and E. Putriyanti, “Tinjauan Literatur: Analisis Waktu Tunggu Pelayanan Poliklinik Rawat Jalan di Rumah Sakit (Literature Review: Analysis of Waiting Times for Outpatient Polyclinic Services in Hospital),” Jurnal Kesehatan, vol. 13, no. 1, pp. 144–153, Jun. 2024.

N. Faris et al., “Electronic medical record implementation in the emergency department in a low-resource country: Lessons learned,” PLoS One, vol. 19, no. 3, pp. 1–13, Mar. 2024, doi: 10.1371/journal.pone.0298027.

T. Wulandari and W. P. Dewi, “The Effectiveness Of The Online Registration System On The Waiting Time for Outpatient Services of Al Ittihad Hospital in Blitar Regency,” Journal of Hospital Management and Services, vol. 7, no. 1, pp. 6–9, 2025.

M. K. Hossain, J. Sutanto, P. W. Handayani, A. A. Haryanto, J. Bhowmik, and V. Frings-Hessami, “An exploratory study of electronic medical record implementation and recordkeeping culture: the case of hospitals in Indonesia,” BMC Health Serv. Res., vol. 25, no. 249, pp. 1–20, Dec. 2025, doi: 10.1186/s12913-025-12399-0.

U. I. Nwagbara, K. W. Hlongwana, and S. C. Chima, “Mapping evidence on the factors contributing to long waiting times and interventions to reduce waiting times within primary health care facilities in South Africa: A scoping review,” PLoS One, vol. 19, no. 8, pp. 1–13, Aug. 2024, doi: 10.1371/journal.pone.0299253.

H. Zhang, W. M. Ma, J. J. Zhu, L. Wang, Z. J. Guo, and X. T. Chen, “How to adjust the expected waiting time to improve patients’ satisfaction?”, BMC Health Serv. Res., vol. 23, no. 455, pp. 1–8, Dec. 2023, doi: 10.1186/s12913-023-09385-9.

K. A. Alarfaj and M. M. H. Rahman, “The Risk Assessment of the Security of Electronic Health Records Using Risk Matrix,” Applied Sciences, vol. 14, no. 5785, pp. 1–14, Jul. 2024, doi: 10.3390/app14135785.

T. Engstrom et al., “The impact of transition to a digital hospital on medication errors (TIME study),” NPJ Digit. Med., vol. 6, no. 133, pp. 1–9, Dec. 2023, doi: 10.1038/s41746-023-00877-w.

F. Nur Azizah and A. Susi Susanti, “The Influence of Implementing an Online Registration System Through the Application on Reducing Queues at The Bandung Muhammadiyah Hospital,” Asian Journal of Environmental Research, vol. 1, no. 2, pp. 66–72, Jul. 2024, doi: 10.69930/ajer.v1i2.55.

D. Salsa, N. Rahmah, and I. J. Fitria, “Analisis Sistem Antrean Online Berbasis SIMRS di RSUD Al Ihsan,” Jurnal Online Manajemen ELPEI (JOMEL), vol. 5, no. 2, pp. 1658–1663, Aug. 2025, [Online]. Available: http://jurnal.stim-lpi.ac.id/index.php/elpei

R. Purwandani, D. Purnamawati, and A. Putri, “Analysis of the implementation of national quality indicator measurement policy on hospital accreditation achievement in Indonesia,” Malahayati International Journal of Nursing and Health Science, vol. 7, no. 12, pp. 1461–1470, Feb. 2025, doi: 10.33024/minh.v7i12.612.

Tunk Raj Kiran, Priyanka Vallu, Ram Mohan Kasi, and Srikanth Gunji, “Optimizing Healthcare Workflows through Technological Implementations,” Int. J. Sci. Res. Sci. Technol., vol. 11, no. 4, pp. 176–182, Jul. 2024, doi: 10.32628/ijsrst2411412.

D. Digdarshinee, “Optimizing Patient Flow in Hospitals: Strategies for Reducing Wait Times and Improving Resource Utilization,” International Journal of Healthcare Sciences, vol. 12, pp. 35–51, 2024, doi: 10.5281/zenodo.14202763.

N. Benahmed, P. Jonckheer, R. Zeevaert, B. Vos, and L. Kohn, “Assessing and Monitoring Waiting Times in Healthcare: How To Proceed In Belgium,” Brussels, 2024. [Online]. Available: www.kce.fgov.be

G. Pascarella et al., “Risk analysis in healthcare organizations: Methodological framework and critical variables,” Risk Manag. Healthc. Policy, vol. 14, pp. 2897–2911, 2021, doi: 10.2147/RMHP.S309098.

O. C. Ezeanyim, E. C. Nwabunwanne, N. C. Igbokwe, and C. O. Nwamekwe, “Patient Flow and Service Efficiency in Public Hospitals: Data-Driven Approaches, Strategies, Challenges, and Future Directions,” Journal Health of Indonesia, vol. 3, no. 02, pp. 104–124, 2025.

A. Arnaout, M. Oseguera-Arasmou, N. Mishra, B. M. Liu, A. Bhattacharya, and D. C. Rhew, “Leveraging Technology In Public-Private Partnerships: A Model To Address Public Health Inequities,” Frontiers in Health Services, vol. 3, pp. 1–5, Jun. 2023, doi: 10.3389/frhs.2023.1187306.