ANALYSIS OF CONSULTATION LENGTH IN KHYBER PAKHTUNKHWA, PAKISTAN
Abstract
Background: Consultation length is considered as direct measure of quality healthcare service and patient satisfaction. We analysed data collected from five different hospitals to inference the effects of sub-factors on consultation length. These factors have positive contribution in predicting the behaviour of consultation length. Methods: We performed cross-sectional study on first hand data collected from 386 participants using snow ball sampling method. The survey instrument was questionnaire and face to face interviews. We considered null hypothesis (H0=0) as means are equal against alternative hypothesis (H1 ‰ 0) for factors of time consumed by overall consultation, patient's history, physical examination, and prescription writing. Data was also analysed by non-parametric univariate tests and multiple linear regression model. Results: Mean of consultation length is 22.466 minutes [CI: 21.420-23.512 and α=0.01]. Null hypothesis (H0=0) was rejected in favour of alternative hypothesis (H1‰ 0) by all factors due to sufficient evidence in data except prescription writing which failed to reject H0. Conclusion: We found factors had high spread in mean values and rejected null hypothesis indicating the duration of health workforces' consultation is varying in different setups. Multiple factors contributed in formation of consultation length of doctors. Similar studies related to conservation of variation in consultation length must consider these factors. Eventually, such studies reporting this variation and its factors will add up in its efficacy and provisioning of appropriate consultation time totting up in patient's satisfaction positively.
References
Wilson A, McDonald P, Hayes L, Cooney J. Health promotion in the general practice consultation: a minute makes a difference. BMJ 1992;304(6821):227-30.
Andersson SO, Ferry S, Mattsson B. Factors associated with consultation length and characteristics of short and long consultations. Scand J Prim Health Care 1993;11(1):61-7.
Deveugele M, Derese A, van den Brink-Muinen A, Bensing J, De Maeseneer J. Consultation length in general practice: cross sectional study in six European countries. BMJ 2002;325(7362):472.
Heaney D, Howie J, Porter A. Factors influencing waiting times and consultation times in general practice. Br J Gen Pract 1991;41(349):315-9.
Heaney DJ, Maxwell M, Howie J. Length of consultations. Consultations should be longer. BMJ 2002;325(7374):1241.
Surbakti EF, Sari K. The Relationship Between Consultation Length and Patient Satisfaction: A Systematic Review. KnE Life Sci 2018;5:41-9.
Howie J, Porter A, Forbes J. Quality and the use of time in general practice: widening the discussion. BMJ 1989;298(6679):1008-10.
Parra C, Jódar-Sánchez F, Jiménez-Hernández MD, Vigil E, Palomino-GarcÃa A, Moniche-Ãlvarez F, et al. Development, implementation, and evaluation of a telemedicine service for the treatment of acute stroke patients: teleStroke. Interact J Med Res 2012;1(2):e15.
Sander U, Emmert M, Dickel J, Meszmer N, Kolb B. Information Presentation Features and Comprehensibility of Hospital Report Cards: Design Analysis and Online Survey Among Users. J Med Internet Res 2015;17(3):e68.
Altebainawi AF, Aljofan M, Alrashidi MN, Alshammari TM. Completeness of medication prescriptions: Prescription errors study in Hail region, Saudi Arabia (PeSHR). Int J Adv Appl Sci 2019;6(12):1-6.
Srinivasulu K. Medico Legal Aspects of Prescription Writing-A Cross Sectional Study. Medico-Leg Update 2013;13(2):41-6.
Biernacki P, Waldorf D. Snowball sampling: Problems and techniques of chain referral sampling. Sociol Methods Res 1981;10(2):141-63.
Cohen N, Arieli T. Field research in conflict environments: Methodological challenges and snowball sampling. J Peace Res 2011;48(4):423-35.
Coleman JS. Relational analysis: the study of social organizations with survey methods. Hum Organ 1958;17(4):28-36.
Seo S. A review and comparison of methods for detecting outliers in univariate data sets: University of Pittsburgh; 2006.
Wallace D, Kecahdi T. Outlier Detection in Health Record Free-Text using Deep Learning. Annu Int Conf IEEE Eng Med Biol Soc 2019;2019:550-5.
Bland JM, Altman DG. Statistics notes: Cronbach's alpha. BMJ 1997;314(7080):572.
Santos JRA. Cronbach's alpha: A tool for assessing the reliability of scales. J Ext 1999;37(2):1-5.
Russell AM, Patel DA, Curtis LM, Kim KYA, Wolf MS, Rowland ME, et al. Test-retest reliability of the Newest Vital Sign health literacy instrument: In-person and remote administration. Patient Educ Couns 2019;102(4):749-52.
Sekaran U. Research methods for business: A skill building approach: John Wiley & Sons; 2006.
IBM Corp N. IBM SPSS statistics for windows. IBM Corp Armonk NY. 2010.
Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika 1951;16(3):297-334.
Altman DG. Statistics in medical journals: developments in the 1980s. Stat Med 1991;10(12):1897-913.
Ben-Gal I. Outlier detection. Data Mining and Knowledge Discovery Handbook: Springer, 2005; p.131-46.
Grubbs FE. Procedures for detecting outlying observations in samples. Technometrics 1969;11(1):1-21.
Walpole RE, Myers RH, Myers SL, Ye K. Probability and statistics for engineers and scientists: Macmillan New York; 1993.
Rice J. Mathematical statistics and data analysis: Nelson Education; 2006.
Kirkwood BR. Essentials of medical statistics: Blackwell Scientific Publications; 1988.
Tu YK, Kellett M, Clerehugh V, Gilthorpe MS. Problems of correlations between explanatory variables in multiple regression analyses in the dental literature. Br Dent J 2005;199(7):457-61.
Perry JJ, Sutherland J, Symington C, Dorland K, Mansour M, Stiell IG. Assessment of the impact on time to complete medical record using an electronic medical record versus a paper record on emergency department patients: a study. Emerg Med J 2014;31(12):980-5.
Ayaki M, Nishihara H, Yaguchi S, Koide R, Kawaguchi T. A Survey of Time Spent by a Physician in Face-to-Face Examination of Outpatients at a General Ophthalmology Clinic. Showa Univ J Med Sci 2005;17(4):185-9.
Wilson A, Childs S. The relationship between consultation length, process and outcomes in general practice: a systematic review. Br J Gen Pract 2002;52(485):1012-20.
Wilson A. Consultation length in general practice: a review. Br J Gen Pract 1991;41(344):119-22.
Orton PK, Pereira Gray D. Factors influencing consultation length in general/family practice. Fam Pract 2016;33(5):529-34.
Jefferson L, Bloor K, Birks Y, Hewitt C, Bland M. Effect of physicians' gender on communication and consultation length: a systematic review and meta-analysis. J Health Serv Res Policy 2013;18(4):242-8.
Kovács N, Varga O, Nagy A, Pálinkás A, Sipos V, Kőrösi L, et al. The impact of general practitioners' gender on process indicators in Hungarian primary healthcare: a nation-wide cross-sectional study. BMJ Open 2019;9(9):e027296.
Wiedermann W, Hagmann M. Asymmetric properties of the Pearson correlation coefficient: Correlation as the negative association between linear regression residuals. Commun Stat-Theory Methods 2016;45(21):6263-83.
Daoud JI. Multicollinearity and Regression Analysis. J Phys 2017;949:012009.
Kim JH. Multicollinearity and misleading statistical results. Korean J Anesthesiol 2019;72(6):558-69.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.