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Consultatieduur in de huisartsenpraktijk: cross-sectionele studie in zes Europese landen.
Deveugele, M., Derese, A., Brink-Muinen, A. van den, Bensing, J., Maeseneer, J. de. Consultatieduur in de huisartsenpraktijk: cross-sectionele studie in zes Europese landen. Huisarts Nu: 2003, 32(9), 464-471
Objectives: To compare determinants of consultation lenght discussed in the literature with those found in consultations with general practitioners from different European countries; to explore the determinants of consultation lenght, particularly the effect of doctors' and patients' perceptions of psychosocial aspects. Design: Analysis of videotaped consultations of general practitioners from the Eurocommunication study and of questionnaires completed by doctors and by patients. Setting: General practices in six European countries. Participants: 190 general practitioners and 3674
patients. Results: In a multilevel analysis with three levels (country, general practitioner, and patient), country and doctor variables contributes a similar amount to the total variance in consulation legth (23% and 22% respectively) and patient variables accounted for 55% of the variance. The variables used in the multilevel analysis explained 25% of the total variation. The country in which the doctor practised, combined with the doctors' variables, was as important for the variance in consultation lenght as the variation between patients. Consultations in which psychosocial problems were considered important by the doctor and the patient lasted longer than consultations about biomedical problems only. The doctor's perception had more influence in this situation than the patient's. Consultation length is influenced by the patients' sex (women got longer consultations), whether the practice was urban or rural, the number of new problems discussed in the consultation (the more problems the longer the consultation), and the patient's age (the older the patient the longer the consultation). As a doctor's workload increased, the lenght of consultations decreased. The general practitioner's sex or age and patient's level of education were not related to the length of consultation. Conclusion: Consultation lenght is determined by variables related to the doctor and the doctor's country as well as by those related to patients. Women consulting in an urban practice with problems perceived as psychosocial have longer
consultations than other patients. (aut.ref.)
patients. Results: In a multilevel analysis with three levels (country, general practitioner, and patient), country and doctor variables contributes a similar amount to the total variance in consulation legth (23% and 22% respectively) and patient variables accounted for 55% of the variance. The variables used in the multilevel analysis explained 25% of the total variation. The country in which the doctor practised, combined with the doctors' variables, was as important for the variance in consultation lenght as the variation between patients. Consultations in which psychosocial problems were considered important by the doctor and the patient lasted longer than consultations about biomedical problems only. The doctor's perception had more influence in this situation than the patient's. Consultation length is influenced by the patients' sex (women got longer consultations), whether the practice was urban or rural, the number of new problems discussed in the consultation (the more problems the longer the consultation), and the patient's age (the older the patient the longer the consultation). As a doctor's workload increased, the lenght of consultations decreased. The general practitioner's sex or age and patient's level of education were not related to the length of consultation. Conclusion: Consultation lenght is determined by variables related to the doctor and the doctor's country as well as by those related to patients. Women consulting in an urban practice with problems perceived as psychosocial have longer
consultations than other patients. (aut.ref.)
Objectives: To compare determinants of consultation lenght discussed in the literature with those found in consultations with general practitioners from different European countries; to explore the determinants of consultation lenght, particularly the effect of doctors' and patients' perceptions of psychosocial aspects. Design: Analysis of videotaped consultations of general practitioners from the Eurocommunication study and of questionnaires completed by doctors and by patients. Setting: General practices in six European countries. Participants: 190 general practitioners and 3674
patients. Results: In a multilevel analysis with three levels (country, general practitioner, and patient), country and doctor variables contributes a similar amount to the total variance in consulation legth (23% and 22% respectively) and patient variables accounted for 55% of the variance. The variables used in the multilevel analysis explained 25% of the total variation. The country in which the doctor practised, combined with the doctors' variables, was as important for the variance in consultation lenght as the variation between patients. Consultations in which psychosocial problems were considered important by the doctor and the patient lasted longer than consultations about biomedical problems only. The doctor's perception had more influence in this situation than the patient's. Consultation length is influenced by the patients' sex (women got longer consultations), whether the practice was urban or rural, the number of new problems discussed in the consultation (the more problems the longer the consultation), and the patient's age (the older the patient the longer the consultation). As a doctor's workload increased, the lenght of consultations decreased. The general practitioner's sex or age and patient's level of education were not related to the length of consultation. Conclusion: Consultation lenght is determined by variables related to the doctor and the doctor's country as well as by those related to patients. Women consulting in an urban practice with problems perceived as psychosocial have longer
consultations than other patients. (aut.ref.)
patients. Results: In a multilevel analysis with three levels (country, general practitioner, and patient), country and doctor variables contributes a similar amount to the total variance in consulation legth (23% and 22% respectively) and patient variables accounted for 55% of the variance. The variables used in the multilevel analysis explained 25% of the total variation. The country in which the doctor practised, combined with the doctors' variables, was as important for the variance in consultation lenght as the variation between patients. Consultations in which psychosocial problems were considered important by the doctor and the patient lasted longer than consultations about biomedical problems only. The doctor's perception had more influence in this situation than the patient's. Consultation length is influenced by the patients' sex (women got longer consultations), whether the practice was urban or rural, the number of new problems discussed in the consultation (the more problems the longer the consultation), and the patient's age (the older the patient the longer the consultation). As a doctor's workload increased, the lenght of consultations decreased. The general practitioner's sex or age and patient's level of education were not related to the length of consultation. Conclusion: Consultation lenght is determined by variables related to the doctor and the doctor's country as well as by those related to patients. Women consulting in an urban practice with problems perceived as psychosocial have longer
consultations than other patients. (aut.ref.)