Do minutes count? Consultation lengths in general practice

Area of Science:

• General Practice and Primary Care
• Health Services Research
• Quality Improvement in Healthcare

Background:

• Consultation length in general practice is a potential indicator of quality, but its variability is not well understood.
• Factors influencing consultation duration, including patient, general practitioner (GP), and practice characteristics, require examination.

Purpose of the Study:

• To quantify the variability in general practice consultation lengths.
• To determine the influence of patient, GP, and practice factors on consultation duration.
• To assess the validity of using consultation length as a quality marker.

Main Methods:

• Multilevel statistical analysis of 836 consultations across 51 general practitioners (GPs) in ten practices.
• Data collected from general practices across four regions in England with diverse characteristics.
• Consultation length measured in minutes, including face-to-face time with patients.

Main Results:

• Substantial inter-practice variation in mean consultation length (5.7 to 8.5 minutes).
• Patient demographics (age, sex), number of topics, and GP characteristics (experience, sex matching patient) significantly affect consultation duration.
• A considerable portion of consultation length variability is explained by patient, GP, and practice factors.

Conclusions:

• Little unexplained variation in general practice consultation lengths suggests limited GP-attributable quality differences.
• The significant influence of non-quality-related factors casts doubt on the reliability of consultation length as a quality marker.
• Further research is needed to identify appropriate quality indicators in general practice.