Stunder W, Scherer M, Himmel W
Lehrbereich Allgemeinmedizin, Albert-Ludwigs-Universität Freiburg, Freiburg.
Dtsch Med Wochenschr. 2008 Jan;133(3):67-70. doi: 10.1055/s-2008-1017475.
This study explored the association between the anticipated and the actual amount of time spent in consultation in a general medical practice and the possible consequences for patient satisfaction.
A total of 95 patients (mean age: 42.4; 55.8 % females) from one general practice were asked before their consultation how much time they anticipated spending with the (53-year-old) doctor. Answers were categorized as "overestimate", "accurate" or "underestimate". At the end of the consultation, patient satisfaction was documented by the patient filling in a standardized questionnaire. Associations between the actual duration of the consultation and the accuracy of the patients' estimate of the time of consultation, patient satisfaction and recorded possible explanatory variables (e.g., sex, age, psychosomatic problems) were analysed by multiple logistic regression.
Half of the patients (48/95) estimated that the consultation would last longer than it actually did. In contrast, significantly more patients with psychosomatic problems underestimated consultation length (38% vs. 10%; adjusted odds ratio = 6.9; 95% confidence interval = 1.9 to 24.3). The actual length of the consultation and patient satisfaction moderately correlated (Spearmans's rho correlation = 0.24 [p = 0.02]). If the length of consultation was shorter than expected, patients were somewhat more dissatisfied.
Only about one-third of patients could accurately gauge ahead of time how long the consultation was going to take. Patients with psychosomatic or severe psychosocial problems took up the largest proportion of the doctor's time, but they significantly underestimated the time the doctor would actually spend with them. Both the predicted estimates of the duration and the actual time spent in consultation seem to influence to some extent patient satisfaction regarding the time spent with the doctor.
本研究探讨了在普通医疗实践中预期咨询时间与实际咨询时间之间的关联,以及对患者满意度可能产生的影响。
来自一家普通诊所的95名患者(平均年龄:42.4岁;55.8%为女性)在咨询前被问及他们预期与(53岁的)医生共度多长时间。答案被分为“高估”、“准确”或“低估”。咨询结束时,患者通过填写标准化问卷记录满意度。通过多元逻辑回归分析咨询的实际时长与患者对咨询时间估计的准确性、患者满意度以及记录的可能解释变量(如性别、年龄、身心问题)之间的关联。
一半的患者(48/95)估计咨询持续时间会比实际更长。相比之下,患有身心问题的患者显著更多地低估了咨询时长(38%对10%;调整后的优势比 = 6.9;95%置信区间 = 1.9至24.3)。咨询的实际时长与患者满意度呈中度相关(斯皮尔曼等级相关系数 = 0.24 [p = 0.02])。如果咨询时长比预期短,患者会更不满意一些。
只有约三分之一的患者能够提前准确判断咨询会持续多长时间。患有身心问题或严重心理社会问题的患者占用医生时间的比例最大,但他们显著低估了医生实际与他们相处的时间。咨询持续时间的预测估计和实际花费时间似乎在一定程度上都会影响患者对与医生相处时间的满意度。