TY - JOUR
T1 - Does the duration of ambulatory consultations affect the quality of healthcare? A systematic review
AU - León-García, Montserrat
AU - Wieringa, Thomas H.
AU - Espinoza Suárez, Nataly R.
AU - Hernández-Leal, María José
AU - Villanueva, Gemma
AU - Ospina, Naykky Singh
AU - Hidalgo, Jessica
AU - Prokop, Larry J.
AU - Calderón, Claudio Rocha
AU - LeBlanc, Annie
AU - Zeballos-Palacios, Claudia
AU - Brito, Juan Pablo
AU - Montori, Victor M.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2023.
PY - 2023/10/23
Y1 - 2023/10/23
N2 - Background The objective is to examine and synthesise the best available experimental evidence about the effect of ambulatory consultation duration on quality of healthcare. Methods We included experimental studies manipulating the length of outpatient clinical encounters between adult patients and clinicians (ie, therapists, pharmacists, nurses, physicians) to determine their effect on quality of care (ie, effectiveness, efficiency, timeliness, safety, equity, patient-centredness and patient satisfaction). Information sources Using controlled vocabulary and keywords, without restriction by language or year of publication, we searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews and Scopus from inception until 15 May 2023. Risk of bias Cochrane Risk of Bias instrument. Data synthesis Narrative synthesis. Results 11 publications of 10 studies explored the relationship between encounter duration and quality. Most took place in the UK's general practice over two decades ago. Study findings based on very sparse and outdated evidence-which suggested that longer consultations improved indicators of patient-centred care, education about prevention and clinical referrals; and that consultation duration was inconsistently related to patient satisfaction and clinical outcomes-warrant low confidence due to limited protections against bias and indirect applicability to current practice. Conclusion Experimental evidence for a minimal or optimal duration of an outpatient consultation is sparse and outdated. To develop evidence-based policies and practices about encounter length, randomised trials of different consultation lengths-in person and virtually, and with electronic health records-are needed.
AB - Background The objective is to examine and synthesise the best available experimental evidence about the effect of ambulatory consultation duration on quality of healthcare. Methods We included experimental studies manipulating the length of outpatient clinical encounters between adult patients and clinicians (ie, therapists, pharmacists, nurses, physicians) to determine their effect on quality of care (ie, effectiveness, efficiency, timeliness, safety, equity, patient-centredness and patient satisfaction). Information sources Using controlled vocabulary and keywords, without restriction by language or year of publication, we searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews and Scopus from inception until 15 May 2023. Risk of bias Cochrane Risk of Bias instrument. Data synthesis Narrative synthesis. Results 11 publications of 10 studies explored the relationship between encounter duration and quality. Most took place in the UK's general practice over two decades ago. Study findings based on very sparse and outdated evidence-which suggested that longer consultations improved indicators of patient-centred care, education about prevention and clinical referrals; and that consultation duration was inconsistently related to patient satisfaction and clinical outcomes-warrant low confidence due to limited protections against bias and indirect applicability to current practice. Conclusion Experimental evidence for a minimal or optimal duration of an outpatient consultation is sparse and outdated. To develop evidence-based policies and practices about encounter length, randomised trials of different consultation lengths-in person and virtually, and with electronic health records-are needed.
UR - http://www.scopus.com/inward/record.url?scp=85175269324&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85175269324&partnerID=8YFLogxK
U2 - 10.1136/bmjoq-2023-002311
DO - 10.1136/bmjoq-2023-002311
M3 - Article
C2 - 37875307
AN - SCOPUS:85175269324
SN - 2399-6641
VL - 12
JO - BMJ Open Quality
JF - BMJ Open Quality
IS - 4
M1 - e002311
ER -