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Table 2 Aims and methodology of cross-sectional studies on consultation length and the management of psychological problems.

From: Do longer consultations improve the management of psychological problems in general practice? A systematic literature review

Author/year

Aim

Duration

No. of practice/doctors

No of patients/consult'n

Mean consult'n length

Method of measuring Consult'n length

Type and method of study

% of eligible participating

Westcott UK 1977 [25]

To study length of general practice consultations and patient characteristics.

2 weeks

1/1-the author

182 patients

8.66 mins

Timed by doctor

Quantitative

Data recorded by doctor

100% of all surgery consultation.

Raynes UK 1980 [38]

To determine which characteristics of GPs, patients & consultations contribute to differences in consultation length, esp. with psychosocial problems.

 

-/10

264

4.2–8.7

Recorded by non-participating observer

Quantitative

Consultations observed and analysed, GP questionnaire

Only 4 patients refused.

1.5%

Hughes UK 1983 [3]

To assess whether length of booked appointments affected consultation outcomes

12 weeks

2/6

1652 consultations

Practice A: 8 min, 4 secs. Booked 10 m Practice B: 5 min 18 s. Booked 5 min

Timed over some sessions

Quantitative

Doctor filled encounter forms

-Not stated

Whitehouse UK-Manchester 1987 [29]

To study factors that influence the management of psychosocial illness in general practice

-

-/201

6870 consultation with psychosocial diagnosis,

<6, 6–6.99, 7–7.99, >8

Recorded by doctor

Quantitative

Doctor encounter forms

40%, representative sample

Andersson 1989 Sweden [37]

To test hypothesis that longer consultations provide greater satisfaction to the doctor & patient.

20–40 consec. Consult'ns

4/7 male doctors with interest in research

160 consultations

21 mins

Doctor recorded-from greeting to farewell

Quantitative

Doctor and patient questionnaire

-Not stated

Howie UK-Lothian (Scotland 1991/1989 [24, 36]

To examine association between different consulting styles, consultation length & prescribing, between quality of consultation, working style of doctors and length of consultation, (slow, intermediate and fast).

1 year

-/85

21,707, 1787 for RTI

Fast <7 mins, Intermediate = 7–8.99, Slow >9 mins

Timed by doctor

Quantitative

Doctor completed encounter forms, some patient questionnaires

17%

Andersson Sweden 1993 [52]

To study factors assoc with short and long consultations

80 consec. consult'ns

3/6-all male

80 each doctor

66 consultations <10 mins, 314 between 11–30 mins 83 >31 mins

Recorded by doctor

Quantitative

Patient questionnaires GP questionnaires

96.4%

Winefield Australia 1996 [40]

To assess relation between patient-centredness (PC), patient satisfaction and consultation length.

Consecutive appointments

-/21

10 per doctor = 210

16.9 mins for high doctor PC, 10.6 mins for low

Audiotapes

Quantitative

Consultations audio taped and analysed for PC

41% GPs 82.5% patients

Martin Australia 1997 [45]

To assess characteristics of longer billed consultations.

1984–1992

-/-

-

Longer consultations>20 or >25 mins Mean = 14.6 mins [54]

Medicare data. Aust Morbidity & Treatment survey ACT Record Linkage survey

Quantitative

Retrospective analysis

Data from government records

AMTS-50.4%

ACT Record Linkage Survey- 94% [48]

Carr-Hill UK 1998 [39]

To study characteristics of patients, GPs and practices associated with variation in consultation length.

2 weeks

10/51

836

GP averages between 4.4–11.0 mins

time with patient, measured by research nurse who sat in

Quantitative Research nurse sat in consultation & recorded data.

Not stated

Blumenthal Boston USA 1999 [30]

To determine the patient, practice, physician and visit characteristics that affect consultation duration.

 

-/686

Random sample picked from 19,192

16.3 mins

Recorded by office staff

Data obtained from 1991–1992 National Ambulatory Medical Care Survey & physician interviews Encounter forms

72% of a random sample of doctors

Howie

UK

UK 1999 [26]

To study relationship between, patient enablement scores, consultation length & quality as measured from NHS data.

2 weeks

53/221

25994

8

Doctor timed

Quantitative Doctor encounter forms & survey, patient questionnaires

38%

Stirling UK, Glasgow 2001 [9]

To examine factors in GP associated with diagnosis & management of psychosocial distress and consultation length

6 months

9 (all accredited for training)/21

1075 consult'ns (about 50 each GP)

8.71 mins (SD = 4.4)

Timed by observer in waiting room

Quantitative Patients completed GHQ-12 and questionnaire, GP rated psychological distress

Not stated

Not representative

Harman New York, USA 2001 [42]

To determine the factors in a doctor's visit associated with recognition of depression

  

17058 consult'ns

16.4 mins without depression, 19.3 mins with depression

Recorded by doctor

Quantitative Data from National Ambulatory Medical Care Survey, 1998 Encounter forms

67.9% of doctors, random sample

Deveugele Belgium, Spain, UK, Switzerland., Germany, Netherlands 2002 [43]

To explore the determinants of consultation length in general practice across six European countries

-

190

3674

G = 7.6, Sp = 7.8, UK = 9.4, N = 10.2, B = 15, SW = 15.6 mins

Measured by stopwatch

Quantitative Videotaped consultations

79% of patients

Telford 2002 UK [34]

To survey GPs' views on barriers to the provision of good management of depression

-

-/1703

-

-

 

Qualitative, cross-sectional GPs sent postal questionnaire

48%

Tahepold Estonia, 2003 [41]

To study influence of patients' age, gender & problem on length of consultation.

 

-/27

405

9.0 mins

Videotaped

Quantitative Videotaped consecutive consultations, analysed

98% of patients Doctors not stated

Britt Australia 2004 [17]

To examine relations between billed consultation length and content.

Apr 2000 – Mar 2002

-/2811

101112

<20 mins, >20 mins Mean = 14.6 mins [54]

Doctor recorded & Medicare data

Quantitative Doctor encounter forms & Medicare item number.

26.1% of random sample of GPs Features of GPs stated [49].

Britt Australia 2005 [27]

To measure effect on consultation length of GP, practice & patient characteristics.

Jan 2001–Dec 2002

-/1904

70758

14.6 mins [54]

Recorded by doctor

Quantitative analysis of data from BEACH study

21.6% of a random sample of GPs. Features of GPs stated [47]

Zantigne The Netherlands 2005 [33]

To investigate whether GPs' workload in consultations is related to psychological or social problems of patients

2000–20002

-/142

1392 consult'ns

9.06–12.65 mins

Videotaped

Quantitative analysis of data from Second Dutch National Survey of General practice

73% of GPs

88.1% of patients

66% consultations

Wright [35]2005 Australia

To study needs of rural GPs, esp in care of depressed patients

-

-/99. 63 male, 36 fem

-

-

-

Quantitative GP sent postal survey

55%