Community Medicine Outpatient Department: Patient profile and reasons for bypass of lower-level public health facilities


  • Sanjeev Kumar Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh
  • Seema Jain Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh
  • Anila Varghese Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh
  • Neelam S Gautam Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh
  • Ramesh Chand Gupta Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh



Community Medicine, Outpatient Care, Tertiary Care, Public Health System


Background: The General OPD under the department of Community Medicine at LLRM Medical College, Meerut was inaugurated with the vision to improve quality of OPD services by reducing the patient burden and waiting time at specialist OPDs. Aim & Objective: To describe the profile of patients attending the Community Medicine OPD in LLRM Medical College, Meerut and to estimate the extent and reasons for bypass of lower-level public health facility by patients attending the general OPD. Settings and Design: A hospital based descriptive study was conducted in the general OPD. Methods and Material: Data of all patients from 1st July,2023 to 31st August,2023 was collected from the registers maintained in the OPD. A sample of 215 patients were selected by systematic random sampling to study the objective to assess bypass of lower-level public health facility. Statistical analysis used: Descriptive statistics. Results: A total of 2570 patients attended the general OPD from 1st July,2023 to 31st August,2023. Around 12.8% patients required referral to specialist OPDs. Most common presenting complaints were respiratory symptoms (29.8%). It was seen that 58.8% patients had bypassed the lower-level public health system and the most common reasons were non-availability of a facility nearby (26.8%), not satisfied with previous experience (23.7%), non-availability of treatment (21.6%) and investigations (17.5%), and lack of awareness of services available at the public health facility (15.4%). Conclusions: The general OPD serves as a model for other medical colleges to emulate and improve the quality of services at tertiary care centres.


Download data is not yet available.


National Health Mission 2013. Last accessed December 25,2023

Issues facing Medical Colleges in India. Last accessed December 25,2023

Chopade RR, Sharma NK, Sundar SM. A time and motion study in outdoor patient department of rural health training centre of tertiary medical college in Konkan region, India. Int J Community Med Public Health 2019;6:3242-5.

Khayyam A U, Patra Somdatta, Sarin R,Singla R, Digamber Behera.A study on overcrowding of out-patient department of a tertiary care tuberculosis institute in Delhi. International Journal of Innovative Research and Review. 2015;3(2):111-116.

Bahadori M, Teymourzadeh E, Ravangard R, Raadabadi M. Factors affecting the overcrowding in outpatient healthcare. J Educ Health Promot. 2017;19;6:21.

Chavan YB, Pande BS. General outpatient department in tertiary care institute: A model to be adopted by medical colleges. J Family Med Prim Care. 2019;15;8(11):3565-3568. . Last accessed December 25,2023 Last accessed December 25,2023

Kishore J, Gupta S, Gedam P. Initiation of the First Preventive Health and Screening Outpatient Department in a Tertiary Teaching Hospital in India. Cureus 2023;15(4): e38115.

Kumar R. Clinical Practice in Community Medicine: Challenges and Opportunities. Indian J Community Med. 2017 Jul-Sep;42(3):131-133.

MD Community Medicine. National Medical Council guidelines.2019. Last accessed December 25,2023

Clark DW: Preventive medicine for the doctor in his community: an epidemiologic approach. Am J Public Health Nations Health. 1958, 48:947.

Salvi S, Apte K, Madas S, et al. Symptoms and medical conditions in 204 912 patients visiting primary health-care practitioners in India: a 1-day point prevalence study (the POSEIDON study). Lancet Glob Health. 2015;3:e776–84

Dawoodi S, Dawoodi I, Dixit P. Gastrointestinal problem among Indian adults: Evidence from longitudinal aging study in India 2017-18. Front Public Health. 2022 Sep 26;10:911354.

Kuntoji SB, Naik AA, Suhas DS.A prospective study of proportion of Helicobacter pylori infection in patients presenting with dyspeptic symptoms in S. Nijalingappa medical college and H.S.K. Hospital, Bagalkot.Int Surg J2020;7:2685-90

Ernst J. Kuipers; Lifestyle and Gastric Function. Dig Dis 2014;32(3):202–205.

Venkatesh U, Sharma A, Ananthan VA, Subbiah P, Durga R; CSIR Summer Research training team. Micronutrient's deficiency in India: a systematic review and meta-analysis. J Nutr Sci. 2021;21;10:e110.

Rao K D, Sheffal A. Quality of clinical care and bypassing of primary health centres in India. Social Science & Medicine volume 2018;207:80-88,

Bagchi, T., Das, A., Dawad, S. et al. Non-utilization of public healthcare facilities during sickness: a national study in India. J Public Health (Berl.) 2022;30:943–951

Pandit A, Varma E, Amruta P. Impact of OPD waiting time on patient satisfaction. International education and research.2016;2:8.

Lee M, Entzminger L, Lohsoonthorn V, Williams MA. Risk factors of hypertension and correlates of blood pressure and mean arterial pressure among patients receiving health exams at the Preventive Medicine Clinic, King Chulalongkorn Memorial Hospital, Thailand. J Med Assoc Thai. 2006;89:1213–21.

OPD Services: [Internet] . Available from: Last accessed December 25,2023

Admission Process | Fortis Healthcare [Internet]. Available from: . Last accessed December 25,2023

WHAT IS UNIQUE ABOUT APHC? [Internet] . Available from: . Last accessed Dec 25,2023

General OPD programme. Central Council for Research in Unani Medicine. Available from: Last accessed December 25,2023




How to Cite

Kumar S, Jain S, Varghese A, Gautam NS, Gupta RC. Community Medicine Outpatient Department: Patient profile and reasons for bypass of lower-level public health facilities. Indian J Community Health [Internet]. 2023 Dec. 31 [cited 2024 Jul. 24];35(4):403-9. Available from:



Original Article

Most read articles by the same author(s)

1 2 > >>