The average American spends a total of about 30 minutes a year with a primary care physician in a system that is less comprehensive than that of Australia or New Zealand, according to a new study comparing primary care practice in the three countries.
Findings showed patient-physician time in the US is about half the average of New Zealand and one-third of Australia.
The substantially shorter time per capita in the US was the biggest difference we saw in our study. Such a severe shortfall impacts preventive care and management of chronic conditions in the US and could explain why the US does not achieve health outcomes that correspond to its higher level of investment in health care," said study lead author Andrew Bindman, MD, of the University of California, San Francisco.
The US primary care average is inadequate for meeting the preventive, acute and chronic needs of the population, he emphasized, noting that it does not even meet the recommendation for preventive care of the Centers for Disease Control and Prevention. This recommendation is for an average of 40 minutes per year for adults and 37 minutes for children. Individuals with chronic care needs are estimated to need an average 20-40 minutes of additional time per condition in primary care.
Previous cross-national research has demonstrated that a strong primary care infrastructure is associated with better health outcomes and lower health costs, said Bindman, who is professor of medicine, epidemiology and biostatistics at UCSF and chief of general internal medicine at San Francisco General Hospital Medical Center.
The new study findings are reported in the online edition of the British Medical Journal ( http://www.bmj.com/cgi/rapidpdf/bmj.39203.658970.55v1) and will appear in the journal's June 16, 2007 print issue. Most country-comparison studies have focused on hospital-based care and procedures, and there has been limited research on the clinical content and duration of visits in primary care, according to the study team.
The researchers used data from an independent survey of primary care physicians in each country and compared mix of patients, diagnoses, scope of practice, and duration of patient visits. Duration of a visit was counted as face-to-face time between the patient and physician and excluded time spent waiting, receiving care from someone other than the physician, and documenting care in a medical record.