Wooldridge Adam N, Arató Nóra, Sen Ananda, Amenomori Masaki, Fetters Michael D
University of Michigan, Department of Family Medicine, 1018 Fuller St, Ann Arbor, MI 48104-1213, USA.
Asia Pac Fam Med. 2010 Nov 23;9(1):11. doi: 10.1186/1447-056X-9-11.
While previous reports examine various aspects of Family Medicine in Japan, there is sparse research on consultation lengths. A common phrase permeates throughout Japan, sanjikan machi, sanpun shinsatsu that means, "Three hour wait, three minute visit." The purpose of this study is to examine consultation length in Japan, and how it is affected by patient variables.
We conducted a case study of consultation length and how it varies in relation to the demographics, presenting illness, and diagnoses at a rural clinic in central Japan. Data were coded according to the standards of the International Classification of Primary Care. Descriptive statistics were obtained to identify features of the data. Further, regression analysis was performed to characterize and to quantify the association between length of consultation and various subject level characteristics.
A total of 263 patients aged 0 - 93 years old had consultations during the 8-day study period. The mean consultation duration was 6.12 minutes. Of all consultations, 11.8% lasted 3 minutes or less. The mean (median) consultation time among males was 6.29 (5.2) minutes and among females was 6.03 (5.4) minutes. The duration of visits increased with age. Among different International Classification of Primary Care categories, psychological issues required the most time (mean = 10.75 min, median = 10.9 min) while urological issues required the least (mean = 5.08 min, median = 4.9 min). The majority of cases seen in the clinic were stable, chronic conditions and required shorter consultation times.
While the mean and median consultation length in this study extends beyond the anecdotal three minutes, the average length of consultation is still remarkably short. Trends affecting consultation length were similar to other international studies. These data present only one aspect of primary care delivery in Japan. To better understand the significance of consultation length relative to the delivery of primary care, future research should examine issues such as continuity, frequency of consultations over time and comprehensiveness of care.
虽然之前的报告探讨了日本家庭医学的各个方面，但关于诊疗时长的研究却很少。在日本，有一个常用的说法贯穿始终，即“三小时等待，三分钟问诊”。本研究的目的是考察日本的诊疗时长，以及它如何受到患者变量的影响。
我们对一家位于日本中部农村诊所的诊疗时长及其与人口统计学特征、就诊疾病和诊断结果之间的关系进行了案例研究。数据按照国际初级保健分类标准进行编码。通过描述性统计来识别数据特征。此外，还进行了回归分析，以描述并量化诊疗时长与各种个体水平特征之间的关联。
在为期8天的研究期间，共有263名年龄在0至93岁之间的患者前来就诊。平均诊疗时长为6.12分钟。在所有诊疗中，11.8%的时长为3分钟或更短。男性的平均（中位数）诊疗时间为6.29（5.2）分钟，女性为6.03（5.4）分钟。就诊时长随年龄增长而增加。在不同的国际初级保健分类类别中，心理问题所需时间最长（平均 = 10.75分钟，中位数 = 10.9分钟），而泌尿系统问题所需时间最短（平均 = 5.08分钟，中位数 = 4.9分钟）。诊所中大多数病例为稳定的慢性病，所需诊疗时间较短。
虽然本研究中的平均和中位数诊疗时长超过了传闻中的三分钟，但平均诊疗时长仍然非常短。影响诊疗时长的趋势与其他国际研究相似。这些数据仅呈现了日本初级保健服务的一个方面。为了更好地理解诊疗时长相对于初级保健服务的重要性，未来的研究应考察诸如连续性、随时间推移的就诊频率以及护理的全面性等问题。
