Abstract
IntroductionWhile previous reports examine various aspects of Family Medicine in Japan, there is sparse research on consultation lengths. A common phrase permeates throughout Japan, sanjikan machi, sanpun shinsatsu that means, "Three hour wait, three minute visit." The purpose of this study is to examine consultation length in Japan, and how it is affected by patient variables.Case DescriptionWe conducted a case study of consultation length and how it varies in relation to the demographics, presenting illness, and diagnoses at a rural clinic in central Japan. Data were coded according to the standards of the International Classification of Primary Care. Descriptive statistics were obtained to identify features of the data. Further, regression analysis was performed to characterize and to quantify the association between length of consultation and various subject level characteristics.Discussion and EvaluationA total of 263 patients aged 0 - 93 years old had consultations during the 8-day study period. The mean consultation duration was 6.12 minutes. Of all consultations, 11.8% lasted 3 minutes or less. The mean (median) consultation time among males was 6.29 (5.2) minutes and among females was 6.03 (5.4) minutes. The duration of visits increased with age. Among different International Classification of Primary Care categories, psychological issues required the most time (mean = 10.75 min, median = 10.9 min) while urological issues required the least (mean = 5.08 min, median = 4.9 min). The majority of cases seen in the clinic were stable, chronic conditions and required shorter consultation times.ConclusionsWhile the mean and median consultation length in this study extends beyond the anecdotal three minutes, the average length of consultation is still remarkably short. Trends affecting consultation length were similar to other international studies. These data present only one aspect of primary care delivery in Japan. To better understand the significance of consultation length relative to the delivery of primary care, future research should examine issues such as continuity, frequency of consultations over time and comprehensiveness of care.
Highlights
While previous reports examine various aspects of Family Medicine in Japan, there is sparse research on consultation lengths
Trends affecting consultation length were similar to other international studies
In contrast to Deveugele et al’s findings on gender differences, we found consultations with men to be longer in absolute time, but not at statistical significance, than consultations with women [20]
Summary
While previous reports examine various aspects of Family Medicine in Japan, there is sparse research on consultation lengths. The purpose of this study is to examine consultation length in Japan, and how it is affected by patient variables. Case Description: We conducted a case study of consultation length and how it varies in relation to the demographics, presenting illness, and diagnoses at a rural clinic in central Japan. There are 277,927 physicians in Japan with 95,213 physicians working in ambulatory clinics Of these 95,213 physicians, 74.8 percent own a solo practice and 25.2 percent work in a group practice [9]. Since they do not have hospital privileges they provide ambulatory-based chronic and acute care, and often home care [10]
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