International variations in primary care physician consultation time: a systematic review of 67 countries

Greg Irving, Ana Luisa Neves, Hajira Dambha-Miller, Ai Oishi, Hiroko Tagashira, Anistasiya Verho, John Holden

Research output: Contribution to journalReview articlepeer-review

423 Citations (Scopus)
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OBJECTIVE: To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes.

DESIGN AND OUTCOME MEASURES: This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes.

RESULTS: One hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction.

CONCLUSION: There are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress.

Original languageEnglish
Article numbere017902
Pages (from-to)e017902
JournalBMJ Open
Issue number10
Early online date8 Nov 2017
Publication statusPublished - 8 Nov 2017


  • Appointments and Schedules
  • Family Practice/organization & administration
  • Humans
  • Office Visits/statistics & numerical data
  • Patient Satisfaction
  • Physician-Patient Relations
  • Physicians, Primary Care/statistics & numerical data
  • Referral and Consultation/statistics & numerical data
  • Time Factors


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