The duration of ambulatory visits to physicians

BACKGROUND. The objective of our study was to determine the typical length of ambulatory visits to a nationally representative sample of primary care physicians, and the patient, physician, practice, and visit characteristics affecting duration of visit. METHODS. We used an analysis of cross-sectional survey data to determine du ration of visit and the characteristics associated with it. The data source s were a random sample of the 19,192 visits by adults to 686 primary care p hysicians contained in the 1991-1992 National Ambulatory Medical Care Surve y, and the results of the Physician Induction Interview conducted by the Na tional Center for Health Statistics. Duration of visit was defined as the t otal time spent in face-to-face contact with the physician. RESULTS. Mean duration of visit was 16.3 minutes (standard deviation = 9.7) . Multivariate analysis allowed the calculation of the independent effect o n visit length of a variety of characteristics of patients, physicians, org anizational/practice setting, geographic location, and visit content. Certa in patient characteristics (increasing age and the presence of psychosocial problems) were associated with increased duration of visit, Visit content was also associated with increased duration, including ordering or performi ng 4 or more diagnostic tests (71% increase), Papanicolaou smears (34%), am bulatory surgical procedures (34%), patient admission to the hospital (32%) , and 3 preventive screening tests (25%). Reduced duration of visit was ass ociated with availability of nonphysician support personnel and health main tenance organization and Medicaid insurance. CONCLUSIONS. Multiple factors affect duration of visit. Clinicians, policym akers, and health system managers should take these considerations into acc ount in managing physician resources during daily ambulatory practice.