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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Factors which influence the length of an out-of-hours telephone consultation in primary care: a retrospective database study

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Mohammed A Mohammed, Gill Clements, Elaine Edwards, Helen Lester
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-430) contains supplementary material, which is available to authorized users.

Competing interests

GC & ED are employees of ShropDOC. MAM has undertaken consultancy work for ShropDOC. HL has no conflicts of interest. The authors declare that they have no competing interests.

Authors’ contributions

MAM conceived of the study with GC and ED and undertook the analysis and drafted the manuscript. HL assisted with interpretation and manuscript writing. All authors contributed to the manuscript and have all read and approved the final manuscript.

Abstract

Background

Given the increasing use of telephone consultation it is important to determine the factors which influence the length of a telephone consultation.

Method

Analysis of 128717 telephone consultations during January to December 2011 to a National Health Service (NHS) out-of-hours primary care service provider in Shropshire and Telford and Powys, England, involving 102 General Practitioners (GPs) and 36 Nurse Practitioners (NPs). Telephone consultation conclude with one of three outcomes – advice only, the patient is invited to a face-to-face consultation with a GP or NP at a nearby health centre (known as a base visit) or the patient is visited at home by a GP or NP (known as home visit). Call length was analysed by these outcomes.

Results

The overall mean call length was 7.78 minutes (standard deviation (SD) 4.77). Calls for advice only were longest (mean 8.11 minutes, SD 5.17), followed by calls which concluded with a base visit (mean 7.36 minutes, SD 4.08) or a home visit (mean 7.16 minutes, SD 4.53). Two primary factors influenced call length. Calls by GPs were shorter (mean 7.15 minutes, SD 4.41) than those by NPs (mean 8.74 minutes, SD 5.31) and calls designated as a mental health call were longer (mean 11.16 minutes, SD 4.75) than all other calls (mean 7.73 minutes, SD 7.7).

Conclusions

Telephone consultation length in the out-of-hours setting is influenced primarily by whether the clinician is a GP or a NP and whether the call is designated as a mental health call or not. These findings suggest that appropriate attempts to reduce the length of the telephone consultations should focus on these two areas, although the longer consultation length associated with NPs is offset to some extent by their lower employment costs compared to GPs. Nonetheless the extent to which the length of a telephone consultation impacts on subsequent use of the health service and correlates with quality and safety remains unclear.
Zusatzmaterial
Authors’ original file for figure 1
12913_2012_2368_MOESM1_ESM.pdf
Authors’ original file for figure 2
12913_2012_2368_MOESM2_ESM.pdf
Authors’ original file for figure 3
12913_2012_2368_MOESM3_ESM.pdf
Literatur
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