Fig. 3

Patient Arrival and Congestion. a Bar graph showing a negative relationship between patient arrival time and the average duration of their clinic visit, superimposed with a line graph showing the number of patients arriving at the clinic within each half-hour block. Patient arrival peaks at 6:30 AM at urban clinics and 6 AM at rural clinics, with a sharp and steady decline in arrival after 7 AM in urban clinics and 8:30 AM in rural clinics. Patients arriving earlier in the day stayed at the clinic longer, on average, than patients arriving later in the day, creating a backlog of patients for clinical staff to see early in the morning. b Utilizing data from a recent CHAI study on patient wait times at Zambian ART clinics, we estimated how much of a patient’s time at the clinic is spent waiting versus receiving care. [6] Assuming that patients are seen on a first-come-first-serve basis, we found that patients arriving prior to clinic opening (before 8 AM) spend a majority of their time waiting for their files to be found and to be called into triage