Patient-Centeredness during In-Depth Consultation in the Outpatient Clinic of a Tertiary Hospital in Korea: Paradigm Shift from Disease to Patient.

Authors:
Kyoung Hee Sohn
Kyoung Hee Sohn
Seoul National University College of Medicine
South Korea
Jungmin Joo
Jungmin Joo
New Drug Development Center
Zhengzhou Shi | China
Yong Jin Kwon
Yong Jin Kwon
College of Medicine

J Korean Med Sci 2019 Apr 22;34(15):e119. Epub 2019 Apr 22.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Background: Patient-centered care (PCC) and integrative care approach are widely advocated. However, their implementation usually requires an extended consultation time. Despite significant advances in medical diagnosis and treatment, no studies have examined consultation time and patient centeredness in Korea.

Methods: We conducted a "15-Minute Consultation" for first-time patients in outpatient clinics of 13 departments. A control group was selected from the same physicians' first-time patients, adjusting for age and gender. A total of 275 patients were selected for receiving in-depth consultation and 141 control patients were selected for regular consultation. Data were collected from patients using a questionnaire comprising a patient-centeredness scale and items on potential predictors such as socio-demographic and clinical factors. We also investigated the participating physician's professionalism.

Results: As compared to the control group, the in-depth consultation group scored higher on 5 variables associated with PCC, including (patients' perception of) medical professionals, wait and consultation times, treatment, patient advocacy, and patient satisfaction. While 92.4% of patients in the in-depth consultation group reported that the consultation time was sufficient, only 69.0% of those in the control group reported the same ( < 0.01). In the in-depth consultation group, scores on satisfaction level were the highest for the department of internal medicine, followed by departments of surgery and pediatrics. Participating physicians' improved satisfaction following the intervention proved that in-depth consultation facilitated building a rapport with patients.

Conclusion: This study illustrated that the provision of sufficiently long consultation for serious and rare diseases could improve PCC and physicians' professionalism. Health authorities should reshuffle the healthcare delivery system and provide sufficient consultation time to ensure PCC and medical professionalism.

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Source
https://jkms.org/DOIx.php?id=10.3346/jkms.2019.34.e119
Publisher Site
http://dx.doi.org/10.3346/jkms.2019.34.e119DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473096PMC
April 2019
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