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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%