case study of doctor-patient encounter in Riyadh primary health care centers, Saudi Arabia

ABSTRACT

1222 consultations [doctor-patient encounters] were selected randomly from 10 primary health care centers which represented 17% of all health centers in urban Riyadh. Tow health centers were selected randomly from each of the five sections of Riyadh [North, South, Centre, East, West]. 32 doctors participated in the study and 9 of them were females. The quality of consultation as reflected by the duration and content of doctor-patient encounter was studied. The data we re collected using a structured questionnaire/interview form. The study was conducted over a period of two weeks during the two main seasons, winter and summer, making a total of four weeks. Every tenth consultation was included. The mean consultation time was 5.69 minutes + SD 4.27 [The mode was 3 minutes]. The following factors were found to increase the mean consultation time male sex, non-Saudi nationals, the high level of education, professional and married status. The doctor's interest in paediatrics was associated with an in crease in mean consultation time. Elderly patients took more time than the younger ones. The elder doctors spent less time with their patients. Other factors which increased or decreased mean consultation time were discussed. Due to pressure of time and more patients waiting to be seen, primary health ca re doctors resorted to issuing prescriptions more than spending time with the patient Doctors tended to manage the presenting problem e.g. Upper respiratory tract infection but forgot or neglected involving the patient in a discussion a med at modifying the help-seeking behavior of the patient or the preventive and health promotive activities. 75% of the consultations ended in prescriptions. The referral rate was 4% and the investigation rate was 13.6% Recommendations for improving the quality of consultation in primary health care settings we resuggested