Purpose The purpose of this paper is to explore healthcare waiting time and the negative and positive effects (i.e. the dual effects) it has on outpatient satisfaction. Design/methodology/approach Self-administered surveys with 334 outpatients and follow-up interviews with 20 outpatients in three large hospitals in Taiwan were conducted to collect data. Findings Quantitative surveys demonstrated that perceived waiting time correlated with satisfaction negatively first but then positively. Satisfaction also correlated with doctor reputation and patient sociability. Follow-up qualitative interviews further revealed that, for some patients, waiting contributed positively to patient evaluations through signaling better healthcare quality and facilitating social interaction. Originality/value This research demonstrated the possibility that waiting might have positive effects on healthcare satisfaction. It also identified variables that could produce greater positive perceptions during hospital waiting and underlying mechanisms that could explain how the positive effects work. This research may potentially help hospitals with a better understanding of how they can improve patients’ waiting experiences and increase satisfaction.

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Waiting is a major course of service dissatisfaction in most health literature. However, are the effects of waiting all negative? This research aims to explore the dual effects (i.e., both the positive and negative effects) of waiting on health service satisfaction. We expect the relationship between waiting time and satisfaction is "inversed U-shape" and to fi nd that under certain circumstances waiting can positively correlate to satisfaction. We also want to understand the moderating roles of service attributes and patient characteristics. We conduct a survey with 334 patients in three large hospitals and in-depth interviews with 20 participants. The results reveal that the relationship between waiting and satisfaction is "U-shape," the left arm curve which shows the negative correlation between waiting and satisfaction indicating that the longer the waiting, the lower the satisfaction. However, the decrease rate of satisfaction slows with the increase of waiting and satisfaction reaches the lowest point at 2.6 h waiting. After this point, satisfaction positively correlates with waiting. Sociability plays a moderating role as that waiting has stronger effects on satisfaction among high-sociability patients. Furthermore, waiting has positive contribution to satisfaction through social interaction and signaling service quality, but these effects may occur in the later stage of waiting.

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