Does the duration of ambulatory consultations affect the quality of healthcare? A systematic review.
Does the duration of ambulatory consultations affect the quality of healthcare? A systematic review.
复制标题
DOI：
10.1136/bmjoq-2023-002311
复制
发表时间：
2023-10
期刊：
影响因子：
1.4
通讯作者：
中科院分区：
文献类型：
--
作者：
其目的是检查和综合现有的最佳实验证据的影响，门诊咨询时间对医疗质量。我们纳入了操纵成年患者和临床医生（即治疗师、药剂师、护士、医生）之间门诊临床接触时间长度的实验研究，以确定它们对护理质量（即有效性、效率、及时性、安全性、公平性、以患者为中心和患者满意度）的影响。使用受控词汇和关键词，不受语言或出版年份的限制，我们检索了MEDLINE、EMBASE、科克伦对照试验中心注册中心和系统评价数据库以及Scopus，从开始到2023年5月15日。科克伦偏倚风险工具。叙事综合。10项研究的11篇出版物探讨了相遇持续时间和质量之间的关系。大多数发生在英国的一般做法超过二十年前。研究结果的基础上非常稀疏和过时的证据，这表明，更长的咨询改善以病人为中心的护理，预防和临床转诊的教育指标，以及咨询时间是不一致的患者满意度和临床结果，保证低的信心，由于有限的保护对偏见和间接适用于目前的做法。关于门诊咨询的最短或最佳持续时间的实验证据是稀疏和过时的。为了制定基于证据的政策和实践，需要对不同的咨询长度进行随机试验，包括面对面和虚拟咨询，以及电子健康记录。OSF注册DOI：10.17605/OSF.IO/EUDK 8.
The objective is to examine and synthesise the best available experimental evidence about the effect of ambulatory consultation duration on quality of healthcare. 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). 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. Cochrane Risk of Bias instrument. Narrative synthesis. 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 Study findings based on very sparse and outdated evidence—which suggested that longer consultations improved indicators of patient-centred care, education about prevention and clinical referrals; and that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. Experimental evidence for a minimal or optimal duration of an outpatient consultation is sparse and outdated.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. OSF Registration DOI:10.17605/OSF.IO/EUDK8.