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| Naji, M. |
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| Motta, Antonella |
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| Aletan, Dirar |
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| Mohamed, Tarek |
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| Ertürk, Emre |
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| Taccardi, Nicola |
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| Kononenko, Denys |
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| Petrov, R. H. | Madrid |
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| Alshaaer, Mazen | Brussels |
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| Bih, L. |
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| Casati, R. |
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| Muller, Hermance |
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| Kočí, Jan | Prague |
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| Šuljagić, Marija |
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| Kalteremidou, Kalliopi-Artemi | Brussels |
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| Azam, Siraj |
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| Ospanova, Alyiya |
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| Blanpain, Bart |
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| Ali, M. A. |
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| Popa, V. |
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| Rančić, M. |
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| Ollier, Nadège |
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| Azevedo, Nuno Monteiro |
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| Landes, Michael |
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| Rignanese, Gian-Marco |
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Perera, Rafael
in Cooperation with on an Cooperation-Score of 37%
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Publications (3/3 displayed)
- 2021Rapid community point-of-care testing for COVID-19 (RAPTOR-C19): protocol for a platform diagnostic study.citations
- 2020Measuring the complexity of general practice consultationscitations
- 2017What carcinoembryonic antigen level should trigger further investigation during colorectal cancer follow-up? A systematic review and secondary analysis of a randomised controlled trialcitations
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article
Measuring the complexity of general practice consultations
Abstract
Background: The complexity of general practice consultations may be increasing and vary in different settings. Testing these hypotheses requires a measure of complexity.<br/><br/>Aim: To develop a valid measure of general practice consultation complexity applicable to routine medical records. <br/><br/>Design: Delphi study to select potential indicators of complexity followed by cross-sectional study to develop and validate a complexity measure. <br/><br/>Setting: English general practices. <br/><br/>Method: An online Delphi study over two rounds involved 32 general practitioners to identify potential indicators of consultation complexity. The cross-sectional study used an age-sex stratified random sample of 173,130 patients and 725,616 general practice face-to-face consultations from 2013/14 in the Clinical Practice Research Datalink. We explored independent relationships between each indicator and consultation duration using mixed effects regression models, and revalidated findings using data from 2017/18. We assessed the proportion of complex consultations in different age-sex groups.<br/><br/>Results: After two rounds, the Delphi panel endorsed 34 of 45 possible complexity indicators. In the cross-sectional study, after excluding factors because of low prevalence or confounding, 17 indicators were retained. Defining complexity as the presence of any of these factors, 308,370 consultations (42.5%) were complex. Mean duration of complex consultations was 10.49 minutes, compared to 9.64 minutes for non-complex consultations. The proportion of complex consultations was similar in men and women but increased with age.<br/> <br/>Conclusion: Our consultation complexity measure has face and construct validity. It may be useful for research, management and policy, informing decisions about the range of resources needed in different practices.