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

Published version
Peer-reviewed

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Type

Article

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Authors

Neves, Ana Luisa 
Dambha-Miller, Hajira  ORCID logo  https://orcid.org/0000-0003-0175-443X
Oishi, Ai 
Tagashira, Hiroko 

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.

Description

Keywords

consultation, global health, primary care, Appointments and Schedules, Family Practice, Humans, Office Visits, Patient Satisfaction, Physician-Patient Relations, Physicians, Primary Care, Referral and Consultation, Time Factors

Journal Title

BMJ Open

Conference Name

Journal ISSN

2044-6055
2044-6055

Volume Title

7

Publisher

BMJ