Time-efficient consultation hours in the department of gynecological endocrinology

The aim was to conduct a benchmark pilot study to find the best practice for consultation hours in the field of gynecological endocrinology. Suitable benchmarking participants were found in China, Germany, Greece, and Switzerland. Specifically, the study aimed to find the most time-efficient and beneficial consultation type in gynecological endocrinology focused on menopause and whether a shorter face-to-face consultation correlates with lower patient satisfaction. This was an observational study. To analyze the processes of all benchmarking participants three tools were used: a measurement of time needed for the different consultation types, a questionnaire for patients and one for physicians. The primary endpoint was the time measurement of first consultations. Secondary endpoints were the time measurements of follow-up consultations and phone consultations and patient satisfaction. The mean overall duration of a first consultation differed from 20.4 min to 39.7 min (<i>p</i> = 0.003), mainly based on differences of the mean time to acquire the patient history, 5.6 to 21.6 min (<i>p</i> &lt; 0.001). The percentage of patients who felt they had enough time to discuss questions ranged from 70% to 100% (<i>p</i> &lt; 0.001). The percentage of patients who felt fully understood by their physician ranged from 62.5% to 92% (<i>p</i> = 0.006). The duration of a first consultation did not correlate with patients feeling well consulted (r=-0.048, <i>p</i> = 0.557). A concise patient history that concentrates on the most relevant points can reduce the total consultation time. Reducing consultation time can be made without compromising how well patients feel consulted.

本研究旨在开展一项基准先导试验（benchmark pilot study），以探寻妇科内分泌学（gynecological endocrinology）领域门诊咨询的最佳实践方案。本次研究的基准参与方分别来自中国、德国、希腊与瑞士。具体而言，本研究旨在探寻聚焦更年期（menopause）的妇科内分泌学领域中，最具时间效率与临床获益的咨询模式，并探究更短时长的面对面咨询（face-to-face consultation）是否与患者满意度降低相关。本研究为观察性研究（observational study）。为分析所有基准参与方的咨询流程，本研究采用了三类工具：针对不同咨询类型所需时长的测量工具、患者问卷与医师问卷。本研究的主要终点（primary endpoint）为首次咨询的时长测量结果；次要终点（secondary endpoint）包括随访咨询与电话咨询的时长测量结果，以及患者满意度。首次咨询的平均总时长介于20.4分钟至39.7分钟之间（p=0.003），差异主要源于采集患者病史（patient history）的平均时长差异——该部分时长介于5.6分钟至21.6分钟之间（p<0.001）。认为自己有充足时间讨论疑问的患者占比介于70%至100%之间（p<0.001）。认为自己被医师完全理解的患者占比介于62.5%至92%之间（p=0.006）。首次咨询时长与患者对咨询服务的良好感知并无相关性（r=-0.048，p=0.557）。聚焦核心要点的简洁化患者病史采集可缩短总咨询时长，且在缩短咨询时长的同时，并不会降低患者对咨询服务的满意感知。