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Do minutes count? Consultation lengths in general practice.

R Carr-Hill1, S Jenkins-Clarke, P Dixon

  • 1Centre for Health Economics, University of York, Heslington, UK.

Journal of Health Services Research & Policy
|September 4, 1998
PubMed
Summary
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Consultation length varies significantly between general practices and is influenced by patient and doctor characteristics, not just quality. This variability questions using consultation duration as a reliable quality marker 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.

Related Experiment Videos

  • 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.