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Cited by 1,083Primary Care and Health OutcomesPatient-Provider Communication in HealthcareHealthcare Systems and Technology

International Variations in Primary Care Physician Consultation Time: A Systematic Review of 67 Countries

Open access
Irving, Greg, Neves, Ana Luisa, Dambha-Miller, Hajira, Oishi, Ai, Tagashira, Hiroko, Verho, Anistasiya, Holden, John·2017·BMJ Open
DOI 10.1136/bmjopen-2017-017902PMC PMC5695512
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Abstract

Objective: To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes. Design and outcome measures: This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes. Results: One hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction. Conclusion: There are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress.

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  • Longer consultations allow for a more thorough assessment, which helps improve diagnoses and reduces the chance of missing important details.

    “Longer consultations allow for a more thorough assessment, which helps improve diagnoses and reduces the chance of missing important details [283,284,285].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [285]

    The Background (page unavailable) reports that longer consultations may improve the accuracy of mental-health diagnoses. The Discussion, under “Main findings and comparison to the literature” (page unavailable), says very short consultations leave little time beyond detecting gross disease. The paper does not establish improved diagnoses generally or show that longer consultations reduce missed details; the Background also notes insufficient evidence of overall patient benefit. (LLM, conf=0.83)

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4 of the 98 references couldn’t be matched to a known paper.

Research works printed but not linked: 15

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Authors
Irving, G., Neves, A. L., Dambha-Miller, H., Oishi, A., Tagashira, H., Verho, A., & Holden, J.
Affiliations
  • University of Cambridge (GB)
  • Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), University of Porto, Porto, Portugal
  • Primary Care Unit, University of Cambridge, Cambridge, UK
  • University of Edinburgh (GB)
  • Horton General Hospital (GB)
  • University of Helsinki (FI)
  • Garswood Surgery, Wigan, UK
Corresponding author
Irving, Greg
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2017-10
Volume
7
Issue
10
Pages
e017902
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2017-017902
PMC
PMC5695512
OpenAlex
W2767996342
Cited by
1,083
References
98
Citations by year
2026: 86 · 2025: 115 · 2024: 123 · 2023: 132 · 2022: 103 · 2021: 120 · 2020: 308 · 2019: 70 · 2018: 21 · 2017: 4
FWCI
19.46
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • Edge Hill University Research Information Repository (Edge Hill University) (submittedVersion, cc-by-nc)
  • Työväentutkimus Vuosikirja (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by-nc)
  • Spiral (Imperial College London) (submittedVersion, cc-by-nc)
Funders
  • World Bank Group
  • Arabian Gulf University
  • National Institute for Health and Care Research (CL-2013-14-001, DRF-2015-08-027)
  • Tel Aviv University
  • Fukushima University
Topics
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
Keywords
physician-patient interaction, international variation, health care spending, hospitalization, physician density, physician efficiency, physician satisfaction, low-income countries, physician workload
MeSH terms
Appointments and Schedules, Family Practice, Humans, Office Visits, Physician-Patient Relations, Referral and Consultation, Time Factors, Patient Satisfaction, Physicians, Primary Care

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