Landau Yael, Vinker Shlomo, Shani Michal, Nakar Sasson
Department of Family Medicine, Central District, Clalit Health Services, Rishon Le-Zion.
Harefuah. 2008 Dec;147(12):1016-20, 1026.
Consultation time is an important resource in primary care, and it is important to understand whether a longer consultation results in better outcomes in morbidity and mortality, and patients' and physicians' satisfaction. Patients' visits may last from 2-3 minutes up to 30 minutes for similar medical problems. The increasing demands from the primary care physician in preventive medicine, complicated care and mental health, have led physicians to feel that the length of time for consultations were insufficient to fulfill these demands. The literature review conducted revealed two forms of research: observational studies where the research examined the relation between consultation length and various outcomes, and intervention studies where different consultation length were compared in order to assess their outcome. The studies are presented in this review according to the parameters that were examined: patients' and doctors' satisfaction, physician stress during the consultation, patients' recurrent visits, diagnosis of depression and psychological problems by the physician, preventive medicine and life style recommendation during consultation, diagnosis and treatment of acute and chronic diseases by the physician, utilization of resources such as prescription number, lab tests and referral to specialists by the physician.
会诊时间是基层医疗中的一项重要资源,了解较长时间的会诊是否能带来更好的发病率和死亡率结果以及患者和医生的满意度非常重要。对于类似的医疗问题,患者就诊时间可能从2 - 3分钟到30分钟不等。基层医疗医生在预防医学、复杂护理和心理健康方面面临的需求不断增加,这使得医生们觉得会诊时间不足以满足这些需求。所进行的文献综述揭示了两种研究形式:观察性研究,即研究考察会诊时长与各种结果之间的关系;干预性研究,即比较不同的会诊时长以评估其结果。本综述根据所考察的参数展示这些研究:患者和医生的满意度、会诊期间医生的压力、患者的复诊情况、医生对抑郁症和心理问题的诊断、会诊期间的预防医学和生活方式建议、医生对急性和慢性疾病的诊断和治疗、资源利用情况,如医生开出的处方数量、实验室检查以及转介给专科医生的情况。