Factors determining perceptions of fairness in access to hospital outpatient departments in Taiwan.

Objectives To investigate the effects of four factors on perceptions of fairness in access to outpatient services: proportions of walk-in versus scheduled registration, consultation queues, regulations for late patients and particular categories of patients getting better access. Methods A total of 124 young adults were asked to consider nine different scenarios and report their views of the fairness of each one. Results As regards the balance of types of patients, 60% walk-in registration was seen as fair to both walk-in and scheduled patients. The fairness to both types of patients was higher in the queue with a 1:1 ratio of walk-in to scheduled patients. The policy that a late patient should wait for three on-time patients to be seen was considered to be fair to both on-time and late patients. Immediate consultation for some particular categories of patient (e.g. the elderly) was fair, but for other categories was unfair (e.g. paying an addition amount). Conclusions Fairness in outpatient care is based on equality and need principles. Shorter waiting time does not mean patients view the system as fairer.