International variations in primary care physician consultation time: a systematic review of 67 countries

ObjectiveTo describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes.Design and outcome measuresThis is a system...

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Veröffentlicht in:BMJ open 2017-10, Vol.7 (10), p.e017902-e017902
Hauptverfasser: Irving, Greg, Neves, Ana Luisa, Dambha-Miller, Hajira, Oishi, Ai, Tagashira, Hiroko, Verho, Anistasiya, Holden, John
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container_end_page e017902
container_issue 10
container_start_page e017902
container_title BMJ open
container_volume 7
creator Irving, Greg
Neves, Ana Luisa
Dambha-Miller, Hajira
Oishi, Ai
Tagashira, Hiroko
Verho, Anistasiya
Holden, John
description ObjectiveTo describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes.Design and outcome measuresThis is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes.ResultsOne hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction.ConclusionThere are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress.
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Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes.ResultsOne hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction.ConclusionThere are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2017-017902</identifier><identifier>PMID: 29118053</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Appointments and Schedules ; Evidence-based medicine ; Family physicians ; Family Practice - organization &amp; administration ; General practice / Family practice ; Global health ; Health services ; Humans ; Inner city ; Office Visits - statistics &amp; numerical data ; Patient Satisfaction ; Physician-Patient Relations ; Physicians ; Physicians, Primary Care - statistics &amp; numerical data ; Primary care ; Quality ; Referral and Consultation - statistics &amp; numerical data ; Researchers ; Systematic review ; Time Factors ; Workloads</subject><ispartof>BMJ open, 2017-10, Vol.7 (10), p.e017902-e017902</ispartof><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>2017 Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b588t-ec10893da1cb1b9ae68d6fe32f4e23813071f3b3c0cb44c897cac0b70852852a3</citedby><cites>FETCH-LOGICAL-b588t-ec10893da1cb1b9ae68d6fe32f4e23813071f3b3c0cb44c897cac0b70852852a3</cites><orcidid>0000-0003-0175-443X ; 0000-0002-9471-3700</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/7/10/e017902.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/7/10/e017902.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27549,27550,27924,27925,53791,53793,77601,77632</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29118053$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Irving, Greg</creatorcontrib><creatorcontrib>Neves, Ana Luisa</creatorcontrib><creatorcontrib>Dambha-Miller, Hajira</creatorcontrib><creatorcontrib>Oishi, Ai</creatorcontrib><creatorcontrib>Tagashira, Hiroko</creatorcontrib><creatorcontrib>Verho, Anistasiya</creatorcontrib><creatorcontrib>Holden, John</creatorcontrib><title>International variations in primary care physician consultation time: a systematic review of 67 countries</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectiveTo describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes.Design and outcome measuresThis is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes.ResultsOne hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction.ConclusionThere are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. 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Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes.ResultsOne hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction.ConclusionThere are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>29118053</pmid><doi>10.1136/bmjopen-2017-017902</doi><orcidid>https://orcid.org/0000-0003-0175-443X</orcidid><orcidid>https://orcid.org/0000-0002-9471-3700</orcidid><oa>free_for_read</oa></addata></record>
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subjects Appointments and Schedules
Evidence-based medicine
Family physicians
Family Practice - organization & administration
General practice / Family practice
Global health
Health services
Humans
Inner city
Office Visits - statistics & numerical data
Patient Satisfaction
Physician-Patient Relations
Physicians
Physicians, Primary Care - statistics & numerical data
Primary care
Quality
Referral and Consultation - statistics & numerical data
Researchers
Systematic review
Time Factors
Workloads
title International variations in primary care physician consultation time: a systematic review of 67 countries
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