Primary Care Clinical Sciences, University of Birmingham, Birmingham, England, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
BMC Health Serv Res. 2012 Nov 26;12:430. doi: 10.1186/1472-6963-12-430.
Given the increasing use of telephone consultation it is important to determine the factors which influence the length of a telephone consultation.
Analysis of 128717 telephone consultations during January to December 2011 to a National Health Service (NHS) out-of-hours primary care service provider in Shropshire and Telford and Powys, England, involving 102 General Practitioners (GPs) and 36 Nurse Practitioners (NPs). Telephone consultation conclude with one of three outcomes - advice only, the patient is invited to a face-to-face consultation with a GP or NP at a nearby health centre (known as a base visit) or the patient is visited at home by a GP or NP (known as home visit). Call length was analysed by these outcomes.
The overall mean call length was 7.78 minutes (standard deviation (SD) 4.77). Calls for advice only were longest (mean 8.11 minutes, SD 5.17), followed by calls which concluded with a base visit (mean 7.36 minutes, SD 4.08) or a home visit (mean 7.16 minutes, SD 4.53). Two primary factors influenced call length. Calls by GPs were shorter (mean 7.15 minutes, SD 4.41) than those by NPs (mean 8.74 minutes, SD 5.31) and calls designated as a mental health call were longer (mean 11.16 minutes, SD 4.75) than all other calls (mean 7.73 minutes, SD 7.7).
Telephone consultation length in the out-of-hours setting is influenced primarily by whether the clinician is a GP or a NP and whether the call is designated as a mental health call or not. These findings suggest that appropriate attempts to reduce the length of the telephone consultations should focus on these two areas, although the longer consultation length associated with NPs is offset to some extent by their lower employment costs compared to GPs. Nonetheless the extent to which the length of a telephone consultation impacts on subsequent use of the health service and correlates with quality and safety remains unclear.
鉴于电话咨询的使用日益增多，确定影响电话咨询时长的因素非常重要。
对 2011 年 1 月至 12 月期间英格兰什罗普郡和特尔福德和波伊斯的国民保健服务（NHS）非工作时间初级保健服务提供商的 128717 次电话咨询进行分析，涉及 102 名全科医生（GP）和 36 名护士从业者（NP）。电话咨询以三种结果之一结束 - 仅提供建议、邀请患者前往附近健康中心与 GP 或 NP 进行面对面咨询（称为基地访问）或 GP 或 NP 上门访问（称为家访）。根据这些结果分析通话时长。
总体平均通话时间为 7.78 分钟（标准差（SD）为 4.77）。仅提供建议的电话时间最长（平均 8.11 分钟，SD 为 5.17），其次是结束于基地访问（平均 7.36 分钟，SD 为 4.08）或家访（平均 7.16 分钟，SD 为 4.53）的电话。有两个主要因素影响通话时长。GP 打的电话比 NP 打的电话短（平均 7.15 分钟，SD 为 4.41），指定为心理健康电话的电话比其他所有电话（平均 7.73 分钟，SD 为 7.7）长（平均 11.16 分钟，SD 为 4.75）。
非工作时间环境中的电话咨询时长主要受临床医生是 GP 还是 NP 以及电话是否指定为心理健康电话的影响。这些发现表明，适当尝试缩短电话咨询的时长应集中在这两个方面，尽管与 GP 相比，NP 的咨询费用较低，但 NP 较长的咨询时间在一定程度上得到了弥补。然而，电话咨询时长如何影响后续使用医疗服务以及与质量和安全的相关性仍不清楚。
