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

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

Objective To 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 measures This 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. 

Results One 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. 

Conclusion There 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.

consultation, global health, primary care
2044-6055
1-15
Irving, Greg
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Neves, Ana Luisa
e2b39758-a4c6-4e13-9ba9-b71185e4509b
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Oishi, Ai
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Tagashira, Hiroko
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Verho, Anistasiya
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Holden, John
a51f50bf-0b7e-463f-a3e1-2f865719f4ac
Irving, Greg
bb904c51-4253-4626-95ae-18bf0b57d926
Neves, Ana Luisa
e2b39758-a4c6-4e13-9ba9-b71185e4509b
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Oishi, Ai
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Tagashira, Hiroko
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Verho, Anistasiya
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Holden, John
a51f50bf-0b7e-463f-a3e1-2f865719f4ac

Irving, Greg, Neves, Ana Luisa, Dambha-Miller, Hajira, Oishi, Ai, Tagashira, Hiroko, Verho, Anistasiya and Holden, John (2017) International variations in primary care physician consultation time:: a systematic review of 67 countries. BMJ Open, 7 (10), 1-15, [e017902]. (doi:10.1136/bmjopen-2017-017902).

Record type: Review

Abstract

Objective To 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 measures This 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. 

Results One 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. 

Conclusion There 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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More information

Accepted/In Press date: 31 July 2017
e-pub ahead of print date: 8 November 2017
Published date: 8 November 2017
Keywords: consultation, global health, primary care

Identifiers

Local EPrints ID: 433421
URI: http://eprints.soton.ac.uk/id/eprint/433421
ISSN: 2044-6055
PURE UUID: 58375162-6be2-43a2-b160-1d037feb9eb5
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X

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Date deposited: 21 Aug 2019 16:30
Last modified: 03 Sep 2022 02:03

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Contributors

Author: Greg Irving
Author: Ana Luisa Neves
Author: Ai Oishi
Author: Hiroko Tagashira
Author: Anistasiya Verho
Author: John Holden

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