Table 4.
Final mixed-effects regression models of patient and consultation factors against consultation duration in the development and validation data sets;a random effects for patient and practice
| 2013/2014 Development (N = 725 616 consultations) | 2017/2018 Validation (N = 234 447 consultations) | |||||
|---|---|---|---|---|---|---|
|
|
|
|||||
| Change, minutes | 95% CI | P-value | Change, minutes | 95% CI | P-value | |
| Consultation factorsa | ||||||
| Mean duration of consultation | 9.78 | 9.56 to 10.00 | <0.001 | 9.81 | 9.38 to 10.24 | <0.001 |
| About drug/alcohol use | 4.19 | 3.68 to 4.69 | <0.001 | 3.73 | 2.54 to 4.92 | <0.001 |
| About chronic pain | 0.98 | 0.86 to 1.10 | <0.001 | 1.00 | 0.79 to 1.21 | <0.001 |
| About dementiab | 1.42 | 0.90 to 1.94 | <0.001 | NA | NA | NA |
| Results in emergency hospital admission | 7.76 | 7.09 to 8.43 | <0.001 | 4.69 | 3.47 to 5.92 | <0.001 |
| About learning disability/autism | 3.84 | 3.17 to 4.52 | <0.001 | 3.05 | 1.98 to 4.12 | <0.001 |
| About mental health problems | 3.85 | 3.70 to 3.99 | <0.001 | 3.83 | 3.58 to 4.08 | <0.001 |
| ≥2 diagnoses from unique Read chapters recorded | 2.54 | 2.42 to 2.67 | <0.001 | 2.86 | 2.61 to 3.12 | <0.001 |
| ≥3 unique substances prescribed | 1.73 | 1.67 to 1.80 | <0.001 | 1.82 | 1.69 to 1.94 | <0.001 |
| ≥2 preventive/routine tasks carried out | 3.73 | 3.55 to 3.92 | <0.001 | 4.81 | 4.44 to 5.19 | <0.001 |
| First consultation after diabetes diagnosis | 3.05 | 2.48 to 3.62 | <0.001 | 2.39 | 1.60 to 3.19 | <0.001 |
|
| ||||||
| Patient factorsa | ||||||
| Mean duration of consultation | 10.02 | 9.80 to 10.25 | <0.001 | 10.03 | 9.60 to 10.46 | <0.001 |
| Drug/alcohol abuse in previous yearb | 1.89 | 1.44 to 2.33 | <0.001 | NA | NA | NA |
| Chronic pain in previous year | 0.72 | 0.57 to 0.87 | <0.001 | 0.75 | 0.51 to 1.00 | <0.001 |
| Domestic violence in last year | 1.43 | 0.37 to 2.49 | 0.008 | 2.37 | 0.99 to 3.74 | <0.001 |
| Homelessness in previous yearb | 1.36 | 0.39 to 2.33 | 0.006 | NA | NA | NA |
| No English noted in last 3 years | 0.98 | 0.25 to 1.72 | 0.009 | 1.01 | 0.12 to 1.91 | 0.026 |
| ≥3 long-term conditionsb | 0.30 | 0.21 to 0.40 | <0.001 | NA | NA | NA |
| Personality/disruptive disorder (ever)b | 0.51 | 0.12 to 0.89 | 0.01 | NA | NA | NA |
a
Based on separate regressions for consultation and patient factors.
b
These variables were retained in the complexity measure despite low prevalence or lack of significant effect in the 2017–2018 model.