CREDIT: This story was first seen in OnMedica
Primary care consultation times last less than five minutes for half the world’s population, and range from 48 seconds in Bangladesh to 22.5 minutes in Sweden, reveals the largest international study of its kind, published in the online journal BMJ Open.
OnMedica reports that the researchers reviewed data on consultation length from 178 relevant studies covering 67 countries and more than 28.5 million consultations, published between 1946 and 2016 in English, Chinese, Japanese, Spanish, Portuguese and Russian. They included both peer reviewed research and the ‘grey literature’- research produced outside of traditional academic or commercial channels.
The results showed that average consultation length varied widely, from 48 seconds in Bangladesh, to 22.5 minutes in Sweden. In 15 countries, which represent around half of the world’s population, the appointment lasted less than five minutes. And it lasted under 10 minutes in a further 25.
In developed countries, average consultation time seemed to steadily increase: by 12 seconds a year to over 20 minutes in the US; and by just over four seconds a year to 10 minutes in the UK. However, the UK started from a low baseline, and on current trends it will only reach a length of 15 minutes by 2086, the researchers pointed out.
Of more concern, they say, is that consultation length seems to be shortening in some low and middle income countries, which may have important implications for population growth and the expansion of treatment options.
Several key findings emerged from the data analysis. Length of consultation was significantly associated with: national spend on healthcare per head of the population, the number of primary care doctors per 1,000 of the population, doctor burnout and ‘depersonalisation’. It was also associated with multiple drugs prescribed to a patient (polypharmacy), overuse of antibiotics, and poor communication with patients.
Although this is the largest international review of consultation length to date, the researchers highlight that the quality of the evidence was graded ‘good’ in less than half the included studies. And differences between rural and urban, and public and private practices, were not taken into account.