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Journal article

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

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.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmjopen-2017-017902

Authors

More by this author
Role:
Author
ORCID:
0000-0002-9471-3700
More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0003-0175-443X


Publisher:
BMJ Publishing Group
Journal:
BMJ Open More from this journal
Volume:
7
Issue:
10
Pages:
e017902
Publication date:
2017-10-01
Acceptance date:
2017-07-31
DOI:
EISSN:
2044-6055
ISSN:
2044-6055
Pmid:
29118053


Language:
English
Keywords:
Pubs id:
pubs:744779
UUID:
uuid:3f6437af-3ecd-4e95-9d95-f4dac3e99985
Local pid:
pubs:744779
Source identifiers:
744779
Deposit date:
2018-01-19
ARK identifier:

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