Doctors’ characteristics and the use of long consultations at out-of-hours services 2008–2017: a registry-based follow-up study in Norway

Abstract

Objective: The aim was to analyse whether there was a change in percentage of long consultations over a 10-year period, and whether individual doctors changed their use of time as they got more experience and specialisation during the same period.

Design and setting: This is a registry based study encompassing all consultations in primary care out-of-hours service in Norway in 2008 and 2017.

Subjects: For both years all doctors were included in cross sectional analyses. In addition, doctors who participated both years were included in a separate follow-up analysis.

Main outcome measures: Long consultations (>20 min) were identified by a time fee in the claims’ database.

Results: There were 4610 doctors in 2008 and 5620 in 2017, 904 participated both years. In 2008 a time fee was claimed in 38% of consultations, in 2017 in 47%. Older doctors made less use of the time fee, as did doctors who had many consultations, regular general practitioners, and general practice specialists. The general practitioners who participated both years increased their use of the time fee from 33% to 38% of consultations. Those who specialised in general practice during the 10-year period increased their use of the time fee from 34% to 37%.

Conclusions: Experienced doctors have fewer long consultations than inexperienced doctors. Over years there is a strong trend towards increasing the use of time fee during out-of-hours consultations. This trend is only partly offset by increasing the experience of the doctors.

KEY POINTS

• Although consultation length may be associated with patient satisfaction there is also a cost-efficiency aspect to be taken into account

• •Percentage long consultations out-of-hours increased from 38% in 2008 to 47% in 2017

• •Experienced doctors had fewer long consultations

• •Experience only partly offset the trend towards more long consultations

Keywords:

• Emergency care
• general practice
• Norway
• out-of-hours medical care
• physician’s practice pattern
• time management

Disclosure statement

The author reports no conflicts of interest.

Ethical approval

The annual statistics were assessed by the data protection officer in the Norwegian Labour and Welfare Administration and the Data Protection Official for Research. Since no individuals can be identified either directly or indirectly in the material, the project was not subject to duty of notification pursuant to the Personal Data Act.