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[General practitioner's workload: objective increase in 9 practices in Rotterdam and surroundings, 1992-1997 and an
J A Harmsen1, R M Bernsen, M A Bruijnzeels
1Instituut Huisartsgeneeskunde, Erasmus Universiteit Rotterdam, Postbus 1738, 3000 DR Rotterdam. harmsen@hag.fgg.eur.nl
Objective:
To assess the change in general practitioners' (GPs') workload during the period 1992-1997, calculated as consult frequency and GP-patient contact time, and to estimate the workload in 2005.
Design:
Descriptive.
Method:
During the period 1992 to 1997, data from all GP-patient contacts from nine general practices in and around Rotterdam, the Netherlands, were registered and stored in a central database. The yearly GP-patient contact time in 1992 and 1997 was calculated using the measured contact frequencies and known figures from the medical literature on the distribution and average duration of the different contact types (consultation, home visit, telephonic consultation, other). The contact time in 2005 was estimated by extrapolating the contact time for the period 1992 to 1997, whilst bearing in mind the expected population composition in 2005.
Results:
The number of GP consultations increased from 4.26 in 1992 to 5.16 in 1997 (+21%). Compared with 1992, the yearly GP-patient contact time in 1997 was at least 90 hours higher. Extrapolation to 2005, revealed a further increase in this contact time of 667 (+36%) hours compared to 1997. This predicted increase in the workload could mostly be attributed to an increase in the number of elderly patients and the number of contacts with these patients.
Conclusion:
The number of hours worked by GPs increased by 20% over a six year period and is expected to increase by about a third over the next few years.