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Primary care visit duration and quality: does good care take longer?
Lena M Chen1, Wildon R Farwell, Ashish K Jha
1Division of General Medicine, University of Michigan Health System, 300 N Ingalls St, Room 7C17, Ann Arbor, MI 48109, USA. lenac@umich.edu
Archives of Internal Medicine
|November 11, 2009
Summary
Primary care visit duration and quality of care increased between 1997 and 2005. While counseling and screening took more time, medication management did not significantly impact visit length, suggesting efficiency gains.
Area of Science:
- Health Services Research
- Primary Care Medicine
- Quality Improvement
Background:
- Investigating the impact of efficiency pressures on primary care physician visit duration and care quality.
- Assessing changes in adult primary care visit length and associated quality of care.
Purpose of the Study:
- To describe trends in adult primary care visit duration and quality.
- To determine the association between quality of care and visit duration.
Main Methods:
- Retrospective analysis of a nationally representative sample of US office-based primary care physicians.
- Examined data from adults aged 18 years and older between 1997 and 2005.
Main Results:
- Adult primary care visits increased, with mean duration rising from 18.0 to 20.8 minutes.
- Visit duration increased for general exams and common diagnoses (diabetes, hypertension, arthropathies).
- Quality of care improved for some screening/counseling and medication indicators; medication adherence was not linked to visit length.
Conclusions:
- Adult primary care visit frequency, quality, and duration all increased from 1997 to 2005.
- Modest associations exist between visit duration and quality of care.
- Counseling/screening required more time, but medication management appeared independent of visit duration.
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