Waiting time and medical consultation length in the Manaus metropolitan region, Brazil: a cross-sectional, population-based study, 2015

Galvão, Taís Freire; Tiguman, Gustavo Magno Baldin; Costa Filho, Douglas Borges da; Silva, Marcus Tolentino

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Brasil

Epidemiologia e Serviços de Saúde

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Sumário

Original articles • Epidemiol. Serv. Saúde 29 (4) • 2020 • https://doi.org/10.5123/S1679-49742020000400014 copy

Waiting time and medical consultation length in the Manaus metropolitan region, Brazil: a cross-sectional, population-based study, 2015^* * Study funded by the National Council for Scientific and Technological Development (CNPq) / Ministry of Science, Technology, Innovation and Communication (MCTIC): Process Numbers 404990/2013-4 and 448093/2014-6.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

. To assess waiting times and length of medical consultations in the Manaus metropolitan region, Brazil.

Methods

. This was a cross-sectional study conducted with adults living in the region in 2015. Waiting time for consultation and length of consultation in minutes were reported by the participants. Analysis was performed using Tobit regression and weighted by the sample design.

Results

. 4,001 individuals were interviewed. Average waiting time was 125.4 minutes (95%CI 120.2;130.5), while consultations lasted an average of 52.5 minutes (95%CI 48.0;57.0). Women, poor people, people with less education, indigenous people, people resident in the state interior, people without health insurance, and individuals seen by gynecologists waited longer for their consultation (p <0.05). Consultation time was shorter for non-White people, those with poor health status and those who had health insurance (p <0.05).

Conclusion

. On average length of medical consultations was half the waiting time. Social inequalities were observed in these lengths of time.

Waiting Lists; Health Services Accessibility; Quality of Health Care; Cross-Sectional Studies; Physicians’ Offices

Variables	n (%)^a	Median (interquartile range)
Variables	n (%)^a	Waiting time (minutes)	Consultation length (minutes)
Age range (years)
18-24	838 (20.9)	80 (30;180)	15 (10;40)
25-34	1.152 (28.8)	90 (40;180)	15 (10;30)
35-44	843 (21.1)	90 (30;180)	15 (10;20)
45-59	772 (19.3)	90 (30;180)	15 (10;25)
≥60	396 (9.9)	60 (28;130)	15 (10;30)
Sex
Male	1.888 (47.2)	65 (30;130)	15 (10;25)
Female	2.113 (52.8)	90 (30;180)	15 (10;30)
Economic classification
A/B	629 (15.7)	60 (30;120)	15 (10;20)
C	2.285 (57.1)	82 (30;180)	15 (10;30)
D/E	1.087 (27.1)	120 (30;180)	15 (10;30)
Educational level
Higher education	158 (4.0)	90 (30;180)	15 (5;25)
High school education	1.903 (47.5)	65 (30;120)	15 (10;30)
Elementary education	649 (16.2)	90 (40;150)	15 (10;20)
Below elementary education	1.291 (32.3)	80 (30;180)	15 (10;30)
Race/skin color
White	636 (15.9)	90 (30;180)	15 (10;61)
Black	300 (7.5)	65 (30;120)	15 (10;20)
Yellow	138 (3.5)	90 (40;150)	15 (10;20)
Brown	2.886 (72.2)	80 (30;180)	15 (10;30)
Indigenous	41 (1.0)	120 (60;180)	10 (5;20)
Health status
Very good/good	2.646 (66.1)	80 (30;180)	15 (10;30)
Regular	1.108 (27.7)	90 (30;180)	15 (10;25)
Poor/very poor	247 (6.2)	100 (30;180)	15 (10;20)
City of residence
Capital (Manaus)	3.479 (86.9)	80 (30;180)	15 (10;30)
Interior	522 (13.2)	120 (30;180)	10 (10;30)
Health insurance
No	3.478 (87.0)	90 (40;180)	15 (10;30)
Yes	523 (13.0)	40 (20;120)	15 (10;25)
Medical specialty at last consultation
Family doctor /general practi-tioner	2.995 (77.1)	80 (30;180)	15 (10;25)
Gynecologist	402 (10.3)	120 (45;180)	15 (10;30)
Specialist	489 (12.6)	60 (30;150)	15 (10;30)

Variables	Waiting time^a		Consultation length^a
Variables	(95%CI^c)	P-value^e	(95%CI^c)	P-value^e
Age range (years)		<0.001		<0.001
18-24	Reference		Reference
25-34	-1.7 (-8.7;5.2)		-8.5 (-12.5;-4.5)	^b
35-44	-0.3 (-7.9;7.2)		-9.2 (-13.4;-5.0)	^b
45-59	-0.2 (-8.1;7.7)		-7.6 (-11.9;-3.2)	^b
≥60	-21.8 (-32.1;-11.6)	^b	-0.8 (-6.6;5.0)
Sex				0.093
Male	Reference		Reference
Female	9.3 (4.2;14.4)	^b	2.4 (-0.4;5.1)
Economic classification		<0.001		<0.001
A/B	Reference		Reference
C	11.3 (4.7;17.9)	^b	6.5 (3.3;9.8)	^b
D/E	17.3 (9.0;25.6)	^b	12.5 (8.2;16.7)	^b
Educational level		0.244		0.064
Higher education	Reference		Reference
High school education	10.1 (-1.9;22.1)		1.9 (-4.2;8.0)
Elementary education	9.0 (-4.4;22.3)		-3.2 (-10.0;3.6)
Below elementary education	13.0 (0.1;25.9)	^b	-0.5 (-7.0;6.0)
Race/skin color		0.001		<0.001
White	Reference		Reference
Black	-19.8 (-29.9;-9.8)	^b	-20.7 (-26.0;-15.5)	^b
Yellow	-12.9 (25.9;0.1)		-23.2 (-28.2;-18.2)	^b
Brown	-10.7 (-17.7;-3.7)	^b	-12.0 (-16.2;-7.7)	^b
Indigenous	7.7 (-15.5;30.9)		-21.3 (-33.5;-9.0)	^b
Health status		0.255		<0.001
Very good/good	Reference		Reference
Regular	1.5 (-4.0;7.1)		-6.3 (-9.1;-3.4)	^b
Poor/very poor	9.1 (-1.8;20.0)		-15.0 (-18.8;-11.1)	^b
City of residence		0.008		0.379
Capital (Manaus)	Reference		Reference
Interior	10.6 (2.8;18.4)	^b	2.0 (-2.5;6.5)
Health insurance		<0.001		<0.001
No	Reference		Reference
Yes	-32.5 (-39.1;-25.9)	^b	-8.8 (-11.9;-5.7)	^b
Medical specialty at last consultation		0.027		0.297
Family doctor /general practitioner	Reference		Reference
Gynecologist	12.0 (3.2;20.8)	^b	3.6 (-1.0;8.2)
Specialist	0.3 (-7.0;7.5)		1.0 (-2.7;4.7)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Gustavo Magno Baldin Tiguman – Universidade Estadual de Campinas, Rua Cândido Portinari, n^o 200, Cidade Universitária, Campinas, SP, Brazil. Postcode: 13083-871 E-mail: gustavo.tiguman@gmail.com