The Impact of Longer Consultation Time: A Simulation-Based Approach

Area of Science:

• Health Services Research
• Operations Research
• Primary Health Care Management

Background:

• Sufficient consultation length is crucial for quality primary health care (PHC), impacting patient safety and satisfaction.
• Limited healthcare capacity and increased consultation times can lead to longer patient wait times and physician work hours.
• Simulation modeling offers a practical approach to quantify workflow impacts and inform decision-making.

Purpose of the Study:

• To evaluate the effect of extended consultation durations on patient waiting times.
• To assess the influence of increased consultation times on physician working hours.

Main Methods:

• Discrete event simulation was employed to model the existing primary health care workflow.
• Five distinct scenarios with varied, extended consultation times were simulated.
• The study analyzed the impact on patient waiting times, physician hours, and staff utilization rates.

Main Results:

• Average patient wait times increased from 9.87 minutes (5-minute consultations) to 89.93 minutes (10-minute consultations).
• The impact of longer consultations on wait times was not uniform; patients arriving later experienced disproportionately longer waits.
• Simulated scenarios with longer consultation times demonstrated higher sensitivity to patient arrival order.

Conclusions:

• Simulation provides a risk-free method to assess the consequences of increasing consultation times in primary health care.
• Extended consultation durations lead to a gradual increase in patient waiting times, with later arrivals waiting longer.
• The order of patient arrival significantly influences wait times, particularly in systems with longer consultation durations.