RT Journal Article
SR Electronic
T1 International variations in primary care physician consultation time: a systematic review of 67 countries
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e017902
DO 10.1136/bmjopen-2017-017902
VO 7
IS 10
A1 Greg Irving
A1 Ana Luisa Neves
A1 Hajira Dambha-Miller
A1 Ai Oishi
A1 Hiroko Tagashira
A1 Anistasiya Verho
A1 John Holden
YR 2017
UL http://bmjopen.bmj.com/content/7/10/e017902.abstract
AB 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.