title: Factors affecting consultation length in a Japanese diabetes practice.
abstract: OBJECTIVE
  Sufficient consultation time is important for establishing good doctor-patient relationship. We examined the factors that affect consultation length in Japanese diabetes practice.
  
  
  METHODS
  This was a cross-sectional study performed at a diabetes clinic in central Tokyo, Japan. Regular diabetes consultations of 1197 patients with 22 physicians were analyzed. Consultation time and clinical characteristics were obtained from the electronic records. A negative binomial model, which included patient and physician characteristics, was constructed to examine the association of the variables with consultation length.
  
  
  RESULTS
  Of the 1197 patients (mean age, 66; women, 25%; type 1 diabetes, 10%), the mean consultation time was 10.1min. In the multivariate model, longer consultation time was recorded in patients with type 1 diabetes, higher glycated hemoglobin (HbA1c), use of insulin injections, and use of hypnotics/anxiolytics. The consultation time was longer in patients with HbA1c of ⩾7.0 to <8.0% (⩾53 to <64mmol/mol), ⩾8.0 to <9.0% (⩾64 to <75mmol/mol) and ⩾9.0% (⩾75mmol/mol), compared to those with HbA1c of <7.0% (<53mmol/mol) with the ratios of 1.03 (95% confidence interval (CI)=0.96-1.10), 1.16 (95% CI=1.07-1.26) and 1.17 (95% CI=1.06-1.29), respectively. Body mass index was also associated with long consultation. Older and female physicians provided longer consultation.
  
  
  CONCLUSIONS
  Clinical consultation length in diabetes practice was associated with certain patient and physician characteristics. The findings can be used for making diabetes consultation more efficacious, which could eventually lead to the provision of the most appropriate consultation time for individual patients.
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Tokai University Hachioji Hospital, Ishikawa-machi 1838, Hachioji, Tokyo 192-0032, Japan. Electronic address: kabeya@tsc.u-tokai.ac.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kabeya
authors.affiliation: Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Mita 1-4-17, Minato-ku, Tokyo 108-0073, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Uchida
authors.affiliation: Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa 259-1193, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Toyoda
authors.affiliation: Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Mita 1-4-17, Minato-ku, Tokyo 108-0073, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Katsuki
authors.affiliation: Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Mita 1-4-17, Minato-ku, Tokyo 108-0073, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Oikawa
authors.affiliation: Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Mita 1-4-17, Minato-ku, Tokyo 108-0073, Japan.
authors.forename: Kiyoe
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Mita 1-4-17, Minato-ku, Tokyo 108-0073, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kawai
authors.affiliation: Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroya-machi, Iruma-gun, Saitama 350-0495, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Shimada
authors.affiliation: Diabetes Center, Eiju General Hospital, Higashi-Ueno 2-23-16, Taito-ku, Tokyo 110-8645, Japan.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Atsumi
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Tokai University Hachioji Hospital, Ishikawa-machi 1838, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Megumu
authors.initials: M
authors.lastname: Higaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013997:Time Factors; D014041:Tokyo / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin
keywords: Consultation length; Diabetes practice; Glycated hemoglobin