Primary care consultations last less than 5 minutes for half the world's population

November 08, 2017

Primary care consultations last less than 5 minutes for half the world's population, but range from 48 seconds in Bangladesh to 22.5 minutes in Sweden, reveals the largest international study of its kind, published in the online journal BMJ Open.

Shorter consultation times have been linked to poorer health outcomes for patients and a heightened risk of burnout for doctors. And as demand for primary health care rises around the globe, the length of a consultation has increasingly come under pressure.

To tease out the potential impact on patients and the wider healthcare system, the researchers reviewed the data on consultation length from 178 relevant studies covering 67 countries and more than 28.5 million consultations.

They included both peer reviewed research and the 'grey literature'--research produced outside of traditional academic or commercial channels--published between 1946 and 2016 in English, Chinese, Japanese, Spanish, Portuguese and Russian.

The results showed that average consultation length varied widely, from 48 seconds in Bangladesh, to 22.5 minutes in Sweden. In 15 countries, which represent around half of the world's population, the appointment lasted less than 5 minutes. And it lasted under 10 minutes in a further 25.

"Little can be achieved in less than 5 minutes unless the focus is largely on detection and management of gross disease," suggest the researchers. "An average of 5 minutes may be the limit below which consultations amount to little more than triage and the issue of prescriptions."

In developed countries, average consultation time seemed to steadily increase: by 12 seconds a year to over 20 minutes in the US; and by just over 4 seconds a year to 10 minutes in the UK. However, the UK started from a low baseline, and on current trends it will only reach a length of 15 minutes by 2086, the researchers point out.

Of more concern, they say, is that consultation length seems to be shortening in some low and middle income countries, which may have important implications for population growth and the expansion of treatment options.

Several key findings emerged from the data analysis. Length of consultation was significantly associated with: But it was not associated with: Shorter consultation length has also been associated with multiple drugs prescribed to a patient (polypharmacy), overuse of antibiotics, and poor communication with patients, the researchers add.

Although this is the largest international review of consultation length to date, the researchers highlight that the quality of the evidence was graded 'good' in less than half the included studies. And differences between rural and urban, and public and private practices, were not taken into account.

But they conclude: "Average time is an established measure of quality and used by the [World Health Organization] and the [International Network for Rational Use of Drugs] as a measure to promote the safe and cost effective use of drugs--it should be universally and regularly reported, and over time, be accepted as an essential measure on the quality of health services around the world."
-end-


BMJ

Related Population Articles from Brightsurf:

Population dynamics and the rise of empires in Inner Asia
In a new study published in Cell, researchers seek to understand the genetic, sociopolitical and cultural changes surrounding the formation of the eastern Eurasian Steppe's historic empires.

Estimating bisphenol exposures in the Australian population
Once found in bottles, food containers, cash register receipts and electronics, bisphenol A (BPA) has been phased out of many products because of health concerns and government regulations.

How will the population accept COVID-19 tracing apps?
Coronavirus tracing applications for the detection of infection chains are currently being developed and made available.

The Lancet: World population likely to shrink after mid-century, forecasting major shifts in global population and economic power
World's population likely to shrink after mid-century, forecasting major shifts in global population and economic power - new analysis, published in The Lancet forecasts global, regional, and national populations, mortality, fertility, and migration for 195 countries worldwide.

Planning for a growing elderly population
The fact that people are living longer lives represents one of the crowning achievements of the last century, but also requires careful planning on the part of governments.

Perpetual predator-prey population cycles
How can predators coexist with their prey over long periods without the predators completely depleting the resource that keeps them alive?

How Human Population came from our ability to cooperate
Humans' ability to cooperate during child-bearing years by sharing food, labor, and childcare duties is the story of population growth.

Population shift resulting in fewer homicides
People are living longer and fewer are having children. This has caused the 15-29 age group to shrink worldwide, a demographic responsible for majority of homicides.

Tommorow's population will be larger, heavier and eat more
Food demand is growing at the same time as people are getting bigger.

UK bumblebee population trends
Data collected by Bumblebee Conservation Trust (BBCT) volunteers to assess the country's changing bumblebee populations have been analyzed in a new way for the first time at the University of Kent -- and show mixed results about their decline, with cause for concern for two species.

Read More: Population News and Population Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.