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

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International variations in primary care physician consultation time: a systematic review of 67 countries

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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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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: Irving, Greg
Dambha-Miller, Hajira
Oishi, Ai
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: gold
doi.org
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 › Medicine › Family Practice › Primary Care and Health Outcomes
Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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