General practitioners' consultation counts and associated factors in Swiss primary care - A retrospective observational study

Abstract

Background: Research on individual general practitioner (GP) workload, e.g. in terms of consultation counts, is scarce. Accurate measures are desirable because GPs' consultation counts might be related to their work satisfaction and arguably, there is a limit to the number of consultations a GP can hold per day without jeopardizing quality of care. Moreover, understanding the association of consultation counts with GP characteristics is crucial given current trends in general practice, such as the increasing proportion of female GPs, part-time work and group practices.

Aim: The aim of this study was to describe GPs' consultation counts and efficiency and to assess associations with GP and practice variables.

Methods: In this retrospective observational study we used routine data in electronic medical records obtained from 245 Swiss GPs in 2018. We described GPs' daily consultation counts as well as their efficiencies (i.e. total consultation counts adjusted for part-time work) and used hierarchical linear models to find associations of the GPs' total consultation counts in 2018 with GP- and practice-level variables.

Results: The median daily consultation count was 28 over all GPs and 33 for full-time working GPs. Total consultation counts increased non-linearly with part-time status, with high part-time working GPs (60%-90% of full-time) being equally or more efficient than full-time workers. Excluding part-time status in the regression resulted in higher consultation counts for male GPs working in single practices and with older patients, whereas part-time adjusted consultation counts were unaffected by GP gender and practice type.

Conclusion: Female gender, part-time work in the range of 60%-90% of full-time, and working in group practices do not decrease GP efficiency. However, the challenge of recruiting sufficient numbers of GPs remains.

Fig 1. Flowchart.

Fig 2. Mean daily consultation counts.

Boxplots of the GPs’ mean daily consultation counts, stratified by part-time status (n = 245 GPs). Widths of boxes are proportional to the square roots of the numbers of GPs in the part-time strata and median values are rounded to whole numbers.

Fig 3. Relative efficiencies.

Boxplots of relative efficiencies stratified by part-time status (n = 245 GPs). Widths of boxes are proportional to the square roots of the numbers of GPs in the part-time strata. The dashed line represents the reference value (efficiency of full-time workers).