International variation in length of primary care consultations
Citation: Irving G, Neves AL, Dambha-Miller H, et al. International variations in primary care physician consultation time: a systematic review of 67 countries. BMJ Open 2017; 7(10): e017902
What is this? The COVID-19 pandemic is placing a strain on healthcare systems. Existing research into the length of primary care consultations between clinicians and patients may provide policy makers with information to help with this.
In this systematic review, the authors searched for observational studies that reported the length of consultations with any primary care clinician. They restricted their search to articles published in Chinese, English, Japanese, Portuguese, Russian and Spanish, and did their search in 2016. They included nearly 180 studies from 67 countries, covering more than 28 million consultations.
What was found: The average length of a primary care consultation varied markedly across countries, from 48 seconds in Bangladesh to nearly 23 minutes in Sweden.
Based on an average from countries that contain about 50% of the global population, a large proportion of the world’s population spent less than 5 minutes on average in a primary care consultation.
Longer consultations in primary care were associated with higher healthcare spending per capita.
Countries with higher numbers of primary care clinicians had longer consultations, regardless of per capita health spending.
Longer consultations in primary care were associated with higher clinician satisfaction and lower rates of burnout from reduced personal accomplishment; but were not associated with patient satisfaction with consultation length.
Longer consultations in primary care were associated with reduced hospital admissions from diabetes; but no difference was noted with admissions from COPD or asthma, or with attendance for accident and emergency care.
Longer consultations were not associated with an increase or decrease in the number of patients seen per year, or a change in the volume of imaging investigations.
Whether there are specific factors to consider for rural versus urban communities is uncertain.
The additional effects of type of practice (public or private) are uncertain.
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