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List sizes and use of time in general practice
1Health Services Research Unit, University of Kent, Canterbury.
British Medical Journal (Clinical Research Ed.)
|November 28, 1987
Summary
Reducing general practice list sizes may not improve care as assumed. Evidence suggests doctors would increase patient visits and reduce work hours, not primarily extend consultation times.
Area of Science:
- General Practice
- Healthcare Management
- Primary Care Research
Background:
- The prevailing assumption is that smaller general practice list sizes allow for longer consultations and improved patient care.
- This study investigates the actual time allocation of general practitioners (GPs) in response to varying list sizes.
Purpose of the Study:
- To examine how general practitioners allocate their time in relation to their patient list sizes.
- To challenge the assumption that reduced list sizes automatically lead to better standards of care through extended consultations.
Main Methods:
- A national random sample of 2104 GPs in England and Wales was surveyed.
- Data collection focused on the allocation and utilization of GPs' time.
- Response rate was 67% with minimal detected bias.
Main Results:
- GPs with smaller personal list sizes spent less time on overall work but had higher consultation rates.
- Further reductions in list sizes would have unpredictable effects across different GP workloads.
- While longer consultations might occur, increased surgery and home visit rates, plus reduced working hours, are more probable outcomes.
Conclusions:
- The anticipated benefits of reduced GP list sizes on consultation length and care standards are questionable.
- Evidence indicates that reduced list sizes are more likely to increase consultation frequency and decrease working hours.
- The impact of list size reduction on GP time allocation and patient care requires a more nuanced understanding.