Do minutes count? Consultation lengths in general practice.
OBJECTIVE
To document the variability in consultation length and to examine the relative weight of different kinds of characteristics (of the patients, of the general practitioner (GP), or of the practice) in affecting consultation length, and, thus, to assess whether consultation length can legitimately be used as a quality marker.


METHODS
A multilevel statistical analysis of 836 consultations across 51 GPs in ten practices.


METHODS
Ten general practices across four regions in England with varying list sizes, number of partners and fundholding status.


METHODS
Length of time face-to-face with patients in consultation measured in minutes and fractions of minutes.


RESULTS
There is substantial inter-practice variation in consultation length, from a mean of 5.7 minutes to one of 8.5 minutes. In some practices the longest average GP consultation time is about twice that of the shortest. Trainees and new partners spend, on average, about 1 minute less than their longer-serving colleagues. Consultation lengths for individual GPs range from a mean of 4.4 minutes to 11 minutes. Late middle-aged women (55-64 years) receive the longest consultations, followed by elderly people, with children receiving the shortest consultations. The number of topics raised affects the length of the consultation by about 1 minute per additional topic. When female patients consult female GPs, approximately 1 minute is added to the average consultation. A significant fraction of the variability in consultation lengths can be explained in terms of characteristics of patients, of GPs and of practices.


CONCLUSIONS
The fact that there is little unexplained variation in GP consultation lengths that might be attributable to variations in quality (i.e. GP-related) throws doubt on the proposition that length of consultation can be used as a marker for quality of consultation in general practice.
Carr-Hill
R
R
Centre for Health Economics, University of York, Heslington, UK.
Jenkins-Clarke
S
S
Dixon
P
P
Pringle
M
M
D000368:Aged; D002648:Child; D005194:Family Practice / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006302:Health Services Research; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D013222:State Medicine; D013996:Time and Motion Studies; D006113:United Kingdom