Practitioner productivity and the product content of medical care in publicly supported health centers

Camasso, Michael J.; Camasso, Anne E.

doi:10.1016/0277-9536(94)90464-2

Cited by 29 publications

(27 citation statements)

References 30 publications

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“…There was a positive relationship between GPs recording a patient's medical and drug history and longer consultation times in our study, a finding that is consistent with Deveugele et al's [5] and other studies [30,31]. Complaints about a new problem will force GPs to make more investigations and so lengthen the consultation time.…”

Section: Physician Factors That Influenced Consultation Timesupporting

confidence: 92%

“…This is consistent with the findings of Hull and Hull [30] and Camasso and Camasso [31]. In rural areas, from an economic point of view, patients may prefer to use medication instead of travelling to the laboratory so the rate of prescribing laboratory tests is usually lower and consultation times are longer in rural regions than urban areas.…”

Section: Physician Factors That Influenced Consultation Timesupporting

confidence: 90%

“…However, as mentioned by previous researchers, accurate assessments of the relationship between patients and G o r g a n K h o r a s a n T e h r a n F a r s K h o z e s t a n K e r m a n s h a h I s f a h a n I r a n physicians is difficult and needs further investigation [19][20][21]. Our study showed that there was a direct and significant relationship between patient satisfaction and consultation time and this agrees with previous studies in other countries [14,27,31,33]. Despite this, we cannot ignore the possible influence of cultural and socioeconomic factors on patient satisfaction in Gorgan.…”

Section: Patient Factors That Influenced Consultation Timesupporting

confidence: 89%

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480 Relationship between consultation length and rational prescribing of drugs in Gorgan city, Islamic Republic of Iran

Khori

Changizi²,

Biuckians³

et al. 2012

East Mediterr Health J

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Doctors with longer consultation times tend to diagnose illnesses more precisely, prescribe fewer drugs and present better health advice to their patients. The aim of this study was to measure the average consultation time of general practitioners in Gorgan, Islamic Republic of Iran and to investigate the factors affecting consultation length, especially in relation to rational prescribing of drugs. Data were collected on 620 patient consultations with 62 randomly selected general practitioners. Mean consultation length was 6.9 (SD 2.6) minutes. Patient factors that were significantly associated with a longer mean duration of consultation time were: higher number of health problems, older age and fewer items of previously used drugs. Physician factors that were significantly associated with a longer mean consultation time were: younger age, higher numbers of items prescribed and injectable drugs prescribed, frequency of interruptions and higher workload.

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Section: Physician Factors That Influenced Consultation Timesupporting

confidence: 92%

Section: Physician Factors That Influenced Consultation Timesupporting

confidence: 90%

Section: Patient Factors That Influenced Consultation Timesupporting

confidence: 89%

See 1 more Smart Citation

480 Relationship between consultation length and rational prescribing of drugs in Gorgan city, Islamic Republic of Iran

Khori

Changizi²,

Biuckians³

et al. 2012

East Mediterr Health J

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“…20 La eficiencia productiva considera como estrategia de Eficiencia y recursos humanos para la salud Artículo originAl medición el volumen de consultas generales generadas por médico, así como la relación entre el volumen de consultas generales y la disponibilidad de médicos por unidad de población. 21,22 A pesar de su relevancia para el cumplimiento de metas y objetivos de los sistemas de salud, los estudios que abordan la eficiencia en RH son escasos, 23 y los existentes no dimensionan sus hallazgos en un marco de eficiencia. El objetivo del presente artículo es explorar la medición de la eficiencia de los RH en la Secretaría de Salud de México en tres dimensiones: en el mercado laboral (vía el desempleo y subempleo de RH), la distribución de RH por nivel de atención y la productividad laboral.…”

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Eficiencia de los recursos humanos en salud: una aproximación a su análisis en México

Nígenda¹,

Alcalde-Rabanal²,

González-Robledo³

et al. 2016

Salud Pública Mex

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salud pública de méxico / vol. 58, no. 5, septiembre-octubre de 2016 Eficiencia y recursos humanos para la salud Artículo originAl Eficiencia de los recursos humanos en salud: una aproximación a su análisis en MéxicoGustavo Nigenda, PhD, (1) Jaqueline Alcalde-Rabanal, PhD, (2) Luz María González-Robledo, PhD,Edson Serván-Mori, M en Econ, (2) Sebastián García-Saiso, M en C, (3) Rafael Lozano, M en Med Soc.(1 Health workers present significant levels of unemployment and underemployment; distribution does not meet international recommendations, and heterogeneous levels of productivity were found among states. Conclusions. Health and educational authorities should develop and implement a HR plan that takes into consideration the needs and demands of the covered population, and includes a clearly defined set of measures to regulate the future production of HR as well as their distribution among and within state health systems, and that allocates incentives to improve performance.

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“…Camasso and Camasso, reporting on physician productivity, found that clinician style determined visit length. 2 Those who averaged four visits per hour were more likely to rely on nurses to deliver services and to request more frequent visits at shorter intervals.…”

Section: Resultsmentioning

confidence: 99%

Impact of gowning on visit length and physical examinations

1998

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We evaluated the effect of a randomized trial of gowning on length of visit and number of physical examinations performed in an outpatient clinic. Nineteen senior internal medicine trainees saw 110 patients without gowns and 113 patients with gowns. Patients without gowns were with the trainees 25.2 ؎ 11.9 (mean ؎ SD) minutes versus 24.2 ؎ 10.3 minutes for gowned patients ( p ‫؍‬ .51). Ungowned patients were in the examination room a total of 38.5 ؎ 15.9 minutes versus 42.9 ؎ 17.6 minutes for gowned patients ( p ‫؍‬ .06). The number of patients that underwent physical examinations was the same (89) for gowned and ungowned groups, and the distribution of the number of examinations by patient group differed only slightly ( p ‫؍‬ .88). Gowning did not significantly decrease the length of visit or increase the number of physical examinations performed. T he emphasis on decreased lengths of inpatient stay, increased delivery of primary care, increased requirements to document the content of the visit for billing and accreditation purposes, and expanded primary care training have led to a major increase in patient activity in the ambulatory care setting at teaching institutions. Our trainees proposed to clinic administration that asking patients to put on gowns would reduce visit times and permit the trainees to be more efficient in their practices. The purpose of this study was to demonstrate whether gowning would result in shorter visits and whether it served as a cue that prompted trainees to perform more physical examinations. METHODSNineteen senior internal medicine trainees (postgraduate year 2 and above) who had a weekly clinic during the 1992-93 academic year participated in the study. One of the 19 was a fellow, and 6 were women. The trainees were not informed about the study in advance. Patients were randomized to gown and no-gown groups, equally balanced, in most circumstances, by intervention and order of intervention within trainees.The clinic nurse asked patients randomized to the gown intervention group to remove their clothing, shoes, and socks, and put on a gown. At the conclusion of each visit, the nurse determined if there was a "used" gown or sheet as the room was prepared for the next patient. A research assistant, located in a central corridor, recorded the total length of time the patient was in the examination room and the time the trainee physician was in the room with the patient.We reviewed charts and recorded which of eight physical examinations were performed: skin, breast, heart, lung, abdominal, genital, rectal, and prostate. The two-sample Student's t test was used to compare the time with trainee and total visit time between the two groups. Ninety-five percent confidence intervals were constructed for the differences between groups in time with trainee and total visit time. The two-sample trend test was used to compare the number of examinations performed. RESULTSTwo-hundred twenty-three patients (5 women and 218 men) were evaluated during the study period. Onehundred ten were randomiz...

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Practitioner productivity and the product content of medical care in publicly supported health centers

Cited by 29 publications

References 30 publications

480 Relationship between consultation length and rational prescribing of drugs in Gorgan city, Islamic Republic of Iran

480 Relationship between consultation length and rational prescribing of drugs in Gorgan city, Islamic Republic of Iran

Eficiencia de los recursos humanos en salud: una aproximación a su análisis en México

Impact of gowning on visit length and physical examinations

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