Nav: Home

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:
    National spend on healthcare per head of the population

    The number of primary care doctors per 1000 of the population

    Doctor burnout and 'depersonalisation'

But it was not associated with:
    The number of consultations per patient in a given year

    The number of diagnostic tests requested by the doctor

    The number of attendances at emergency care departments

    Patient satisfaction

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:

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.
Overall well-being of a population associated with less per capita medicare spending
A new study in JAMA Network Open finds that the overall well-being of a population on a county level is associated with lower healthcare spending for each Medicare fee-for-service beneficiary.
More Population News and Population Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.