Structure and duration of consultations in Estonian family practice.

OBJECTIVE

To study the influence of age, gender and the nature of the patient's problems on length of time of consultation in the practices of newly trained family doctors in a recently reconstructed health care system.

DESIGN

Video-recordings of consultations with consecutive patients in family practice were studied for duration of consultation in relation to age, gender and nature of the problem(s).

SETTING

Primary health care.

SUBJECTS

405 consecutive consultations were video-taped in the practices of 27 family doctors.

MAIN OUTCOME MEASURES

Length of time of consultation and its segments was analysed using the Statistical Package for the Social Sciences. The problems were classified according to the ICPC.

RESULTS

The average consultation lasted 9.0 min (+/- 4.9). Physical examination was 2.0 min (+/- 1.9) and was performed in 79% of all consultations. Respiratory and circulatory problems were the most common. More than one reason for the encounter was given in one-fourth of cases. Consultation time was longer for older age groups and for patients with psychological problems.

CONCLUSION

Video-recording allows consultations to be evaluated directly and is acceptable to patients. The high participation rate of patients in our study can be explained by the individual approach and by the family doctor system. The period of consultation was dependent on patient age and on the number and nature of the problems, but was not influenced by gender.