Abstract:
Health care is a fundamental need and right of any civilized community and health care
systems have been developed from time immemorial to provide this essential need. Basic
goals of a health care delivery system are; provision of health care, fair financing and
responsiveness. In provision of health care, it is essential to consider equity and access to
health care. Cost of health care is gaining importance in a rapidly economizing world and
patient satisfaction has become an essential consideration in service provision in recent
years. To Evaluate Specialist Outreach Clinics conducted in selected districts with reference
to improvement of Geographical and Temporal accessibility, Service Outcome, Patient
satisfaction, Cost to the patient and service provider, contribution to reduce overcrowding in
secondary and tertiary level of health care and possible contribution to increasing utilization
of inpatient services at primary care level. Geographical and convenience of access to
specialist services was significantly improved through outreach clinics. Waiting time
reduction for Wariyapola and Mahawa outreach was significantly less at 99 percent level.
For Piliyandala Outreach it was significant at 95 percent Level. Cost for the patients was
significantly reduced due to outreach specialist clinics. In terms of cost efficiency and
service outcome, Wariyapola Rheumatology clinic was the best and in terms of patient
satisfaction it was Mahawa Antenatal clinic. Patients were mostly satisfied with outreach
clinics due to the improvement of geographical access and due to performance of staff. They
perceive money and time savings as the most advantageous. Medical officers felt that
convenience of access for patients, reduction of overcrowding and improvement of
knowledge and skills of primary care officers were the main advantages. Secondary data
survey revealed that, there is no improvement in bed occupancy rates in primary care
institutions, where outreach clinics are held. But there was a reduction in overcrowding in
Rheumatology and Antenatal clinics of Kurunegala T.H. after the commencement of
outreach clinics. Patients obtain significant improvement in access to specialist services,
cost reduction and satisfaction through outreach specialist clinics. Those in Kurunegala
District were the more beneficial. Thus it could be inferred that outreach services to less
accessible communities are beneficial
