Length of Office Visits for Gastrointestinal Disease: Impact of Physician Specialty
Length of Office Visits for Gastrointestinal Disease: Impact of Physician Specialty
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DOI：
10.1038/ajg.2010.172
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发表时间：
2010-08-01
影响因子：
9.8
通讯作者：
Saeian, Kia
中科院分区：
文献类型：
--
作者：
Ananthakrishnan, Ashwin N.;McGinley, Emily L.;Saeian, Kia
目标：医生就诊时间是患者满意度和结果的重要决定因素。我们的目的是比较胃肠病学家和初级保健提供者 (PCP) 之间胃肠道疾病的就诊时间。 方法：根据全国门诊医疗服务调查，确定了 1993 年至 2004 年间对办公室医生诊所的就诊次数，并使用多变量回归来确定就诊时间的预测因素。 结果：与胃肠道疾病相关的就诊次数分别为 3135、3391 和 3964 次，对应于 71、3391 和 3964 次。 1993-1996年、1997-2000年和2001-2004年全国访问量分别为140和1.8亿人次。所有医生的就诊时间从1993-1996年的17.3分钟增加到2001-2004年的20.2分钟。胃肠病学家的就诊时间保持不变，从 1993-1996 年的 21.0 分钟增加到 2001-2004 年的 22.3 分钟。在多变量回归中，年龄>50岁（1.8分钟）、新患者就诊（7.4分钟）以及1997-2000年（2.7分钟）和2001-2004年（3.4分钟）的就诊与较长的就诊时间相关。与胃肠病专家的会面（3.3 分钟）比与 PCP 的会面时间更长。两者之间调整后的就诊时间差异最大的是与便秘相关的就诊时间（胃肠病专家为 5.7 分钟）和肠易激综合征相关的就诊时间（2.4 分钟）。结论：与胃肠道疾病相关的就诊时间总体有所增加。患者和提供者因素都可以预测就诊时间。
OBJECTIVES: Physician-visit length is an important determinant of patient satisfaction and outcomes. Our objective was to compare visit length for gastrointestinal disorders between gastroenterologists and primary-care providers (PCPs).METHODS: From the National Ambulatory Medical Care Survey, visits to office-based physician practices between 1993 and 2004 were identified and multivariate regression was used to identify predictors of visit duration.RESULTS: There were 3135, 3391, and 3964 office visits associated with gastrointestinal disease, corresponding to 71, 140, and 180 million visits nationwide in 1993-1996, 1997-2000, and 2001-2004 respectively. Visit duration to all physicians increased from 17.3 minutes in 1993-1996 to 20.2 minutes in 2001-2004. Among gastroenterologists, visit length remained constant, from 21.0 minutes in 1993-1996 to 22.3 minutes in 2001-2004. On multivariate regression, age >50 years (1.8 minutes), new-patient encounters (7.4 minutes), and visits in 1997-2000 (2.7 minutes) and 2001-2004 (3.4 minutes) were associated with longer visit length. Encounters with gastroenterologists (3.3 minutes) were associated with longer visit duration than those with PCPs. The greatest adjusted difference in visit length between the two was seen for visits associated with constipation (5.7 minutes favoring gastroenterologists) and irritable bowel syndrome (2.4 minutes).CONCLUSIONS: There has been an overall increase in length of physician visits associated with gastrointestinal disease. Both patient and provider factors predict visit length.