ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2021
Measuring the complexity of general practice consultations: a Delphi and cross-sectional study in English primary care.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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19 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Older Patients' Verbal Communication in Interactions With Primary Care Staff: A Qualitative Systematic Review and Meta-Ethnography.Health expectations : an international journal of public participation in health care and health policy · 2025Pooled it
- Consultation complexity and professionals consulted: a retrospective cohort study in English primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Digital morphine: why AI scribes are symptomatic relief for a broken system.BMJ digital health & AI · 2026Article
- Multimorbidity research in dementia: it's time to shift to a person-centred approach.Frontiers in dementia · 2026Article
- What makes patients in primary care complex? A scoping review combined with a focus group analysis.Scandinavian journal of primary health care · 2025Article
- The impact of COVID-19 lockdowns on primary care contact among vulnerable populations in England: a controlled interrupted time-series study.BJGP open · 2025Article
- Analysis of the increase in the complexity of care in family medicine.BMC primary care · 2025Observational
- Article
- Shattering the Shield: Embracing Complexity in Undergraduate Medical Education.The clinical teacher · 2025Article
- On Lateness: The Ethics of Running Behind Schedule in General Practice.Journal of evaluation in clinical practice · 2025Article
- Exploring Complexity in Out-of-Hospital Clinical Supervision Using Rich Pictures.Perspectives on medical education · 2025Article
- How family physicians in Singapore recognise complexity during consultations: a qualitative study.BMC primary care · 2024Article
- What can publicly funded schools teach us about how to fix the family doctor shortage?Healthcare management forum · 2023Article
- Evaluation of Complexity Measurement Tools for Correlations with Health-Related Outcomes, Health Care Costs and Impacts on Healthcare Providers: A Scoping Review.International journal of environmental research and public health · 2022Article
- Complex skills are required for new primary health care researchers: a training program responds.BMC medical education · 2022Article
- Understanding the processes behind the decisions - GPs and complex multimorbidity decision making.BMC primary care · 2022Article
- Health complexity assessment in primary care: A validity and feasibility study of the INTERMED tool.PloS one · 2022Article
- Protocol: Remote care as the 'new normal'? Multi-site case study in UK general practice.NIHR open research · 2022Article
- The aim of general practice: can it be explained in one sentence?The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe complexity of general practice consultations may be increasing and varies in different settings. A measure of complexity is required to test these hypotheses.
aimTo develop a valid measure of general practice consultation complexity applicable to routine medical records. DESIGN AND
settingDelphi study to select potential indicators of complexity followed by a cross-sectional study in English general practices to develop and validate a complexity measure.
methodThe online Delphi study over two rounds identified potential indicators of consultation complexity. The cross-sectional study used an age-sex stratified random sample of patients and general practice face-to-face consultations from 2013/2014 in the Clinical Practice Research Datalink. The authors explored independent relationships between each indicator and consultation duration using mixed-effects regression models, and revalidated findings using data from 2017/2018. The proportion of complex consultations in different age-sex groups was assessed.
resultsA total of 32 GPs participated in the Delphi study. The Delphi panel endorsed 34 of 45 possible complexity indicators after two rounds. After excluding factors because of low prevalence or confounding, 17 indicators were retained in the cross-sectional study. The study used data from 173 130 patients and 725 616 face-to-face GP consultations. On defining complexity as the presence of any of these 17 factors, 308 370 consultations (42.5%) were found to be 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 males and females but increased with age.
conclusionThe present consultation complexity measure has face and construct validity. It may be useful for research, management and policy, and for informing decisions about the range of resources needed in different practices.
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