Division of Pulmonary and allergy, Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea.
Institute of Public Health Medical Service, Seoul National University Hospital, Seoul, Korea.
J Korean Med Sci. 2019 Apr 22;34(15):e119. doi: 10.3346/jkms.2019.34.e119.
Patient-centered care (PCC) and integrative care approach are widely advocated. However, their implementation usually requires an extended consultation time. Despite significant advances in medical diagnosis and treatment, no studies have examined consultation time and patient centeredness in Korea.
We conducted a "15-Minute Consultation" for first-time patients in outpatient clinics of 13 departments. A control group was selected from the same physicians' first-time patients, adjusting for age and gender. A total of 275 patients were selected for receiving in-depth consultation and 141 control patients were selected for regular consultation. Data were collected from patients using a questionnaire comprising a patient-centeredness scale and items on potential predictors such as socio-demographic and clinical factors. We also investigated the participating physician's professionalism.
As compared to the control group, the in-depth consultation group scored higher on 5 variables associated with PCC, including (patients' perception of) medical professionals, wait and consultation times, treatment, patient advocacy, and patient satisfaction. While 92.4% of patients in the in-depth consultation group reported that the consultation time was sufficient, only 69.0% of those in the control group reported the same ( < 0.01). In the in-depth consultation group, scores on satisfaction level were the highest for the department of internal medicine, followed by departments of surgery and pediatrics. Participating physicians' improved satisfaction following the intervention proved that in-depth consultation facilitated building a rapport with patients.
This study illustrated that the provision of sufficiently long consultation for serious and rare diseases could improve PCC and physicians' professionalism. Health authorities should reshuffle the healthcare delivery system and provide sufficient consultation time to ensure PCC and medical professionalism.
以患者为中心的护理（PCC）和综合护理方法得到广泛倡导。然而，它们的实施通常需要延长咨询时间。尽管在医学诊断和治疗方面取得了重大进展，但在韩国还没有研究检查咨询时间和以患者为中心的问题。
我们在 13 个科室的门诊为首次就诊的患者进行了“15 分钟咨询”。选择了来自同一医生首次就诊的对照组，根据年龄和性别进行调整。共选择了 275 名患者进行深入咨询，选择了 141 名对照患者进行常规咨询。使用包含以患者为中心的量表和社会人口统计学及临床因素等潜在预测因子的问卷，从患者那里收集数据。我们还调查了参与医生的专业精神。
与对照组相比，深入咨询组在与 PCC 相关的 5 个变量上的得分更高，包括（患者对）医疗专业人员、等待和咨询时间、治疗、患者倡导和患者满意度的看法。尽管深入咨询组 92.4%的患者报告咨询时间充足，但对照组中只有 69.0%的患者报告了同样的情况（<0.01）。在深入咨询组中，对内科的满意度评分最高，其次是外科和儿科。参与医生对干预后的满意度提高证明，深入咨询有助于与患者建立融洽关系。
本研究表明，为严重和罕见疾病提供足够长的咨询时间可以提高以患者为中心的护理和医生的专业精神。卫生当局应重新调整医疗服务提供系统，并提供足够的咨询时间，以确保以患者为中心的护理和医疗专业精神。
