TY - JOUR
T1 - Revisiting the Time Needed to Provide Adult Primary Care
AU - Porter, Justin
AU - Boyd, Cynthia
AU - Skandari, M. Reza
AU - Laiteerapong, Neda
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Society of General Internal Medicine.
PY - 2023/1
Y1 - 2023/1
N2 - Background: Many patients do not receive guideline-recommended preventive, chronic disease, and acute care. One potential explanation is insufficient time for primary care providers (PCPs) to provide care. Objective: To quantify the time needed to provide 2020 preventive care, chronic disease care, and acute care for a nationally representative adult patient panel by a PCP alone, and by a PCP as part of a team-based care model. Design: Simulation study applying preventive and chronic disease care guidelines to hypothetical patient panels. Participants: Hypothetical panels of 2500 patients, representative of the adult US population based on the 2017–2018 National Health and Nutrition Examination Survey. Main Measures: The mean time required for a PCP to provide guideline-recommended preventive, chronic disease and acute care to the hypothetical patient panels. Estimates were also calculated for visit documentation time and electronic inbox management time. Times were re-estimated in the setting of team-based care. Key Results: PCPs were estimated to require 26.7 h/day, comprising of 14.1 h/day for preventive care, 7.2 h/day for chronic disease care, 2.2 h/day for acute care, and 3.2 h/day for documentation and inbox management. With team-based care, PCPs were estimated to require 9.3 h per day (2.0 h/day for preventive care and 3.6 h/day for chronic disease care, 1.1 h/day for acute care, and 2.6 h/day for documentation and inbox management). Conclusions: PCPs do not have enough time to provide the guideline-recommended primary care. With team-based care the time requirements would decrease by over half, but still be excessive.
AB - Background: Many patients do not receive guideline-recommended preventive, chronic disease, and acute care. One potential explanation is insufficient time for primary care providers (PCPs) to provide care. Objective: To quantify the time needed to provide 2020 preventive care, chronic disease care, and acute care for a nationally representative adult patient panel by a PCP alone, and by a PCP as part of a team-based care model. Design: Simulation study applying preventive and chronic disease care guidelines to hypothetical patient panels. Participants: Hypothetical panels of 2500 patients, representative of the adult US population based on the 2017–2018 National Health and Nutrition Examination Survey. Main Measures: The mean time required for a PCP to provide guideline-recommended preventive, chronic disease and acute care to the hypothetical patient panels. Estimates were also calculated for visit documentation time and electronic inbox management time. Times were re-estimated in the setting of team-based care. Key Results: PCPs were estimated to require 26.7 h/day, comprising of 14.1 h/day for preventive care, 7.2 h/day for chronic disease care, 2.2 h/day for acute care, and 3.2 h/day for documentation and inbox management. With team-based care, PCPs were estimated to require 9.3 h per day (2.0 h/day for preventive care and 3.6 h/day for chronic disease care, 1.1 h/day for acute care, and 2.6 h/day for documentation and inbox management). Conclusions: PCPs do not have enough time to provide the guideline-recommended primary care. With team-based care the time requirements would decrease by over half, but still be excessive.
KW - Chronic disease care
KW - Population health
KW - Preventive care
KW - Primary care
KW - Team-based care
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U2 - 10.1007/s11606-022-07707-x
DO - 10.1007/s11606-022-07707-x
M3 - Article
C2 - 35776372
AN - SCOPUS:85133285615
SN - 0884-8734
VL - 38
SP - 147
EP - 155
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 1
ER -