Patient–physician communication during oncological follow-up visits in a Chinese outpatient clinic

Abstract

Abstract Background As the number of cancer survivors rises, patient care focus has recently shifted towards outpatient services, emphasizing the management of chronic conditions. As health systems struggled to meet the increasing demands, a greater emphasis has been placed on improving the efficiency of outpatient visits. However, given the restricted visitation duration in China’s crowed outpatient clinics, it remains uncertain whether symptoms induced by cancer or its treatment receive adequate treatment. Objective We aimed to analyze the duration of routine follow-up visits for patients with cancer and the nature of their communication with doctors during these visits. Improving oncological outpatient services and reducing work pressure on oncologists, by identifying the core needs of cancer patients and determining the time required for physicians to address these needs. Method From Oct-Nov 2022, patients in the oncology outpatient clinic at a tertiary A hospital in China were recruited. Demographic and disease characteristics of patients were collected in the outpatient clinic, and fixed-effects models were used to analyze factors affecting the visit length. Results Total 488 established patients and 28 newly diagnosed patients were involved. The median duration taken by physicians to attend to the new and established groups was 7 minutes (4–11 minutes) and 4 minutes (3–7 minutes), respectively. Among the established patients, those for regular outpatient follow up (79.71%) spent 4 minutes (3–6 minutes) with their doctors, those for therapy counseling (10.86%) spent 6 minutes (4–9 minutes), those for insurance reimbursement (4.92%) spent 5 minutes (4–7.5 minutes), those for symptoms distress (4.51%) spent 6.5 minutes (4–9 minutes). The following attributes had significant impact on the visit time: the composition of visitors (OR = 0.57 [95% CI, 0.23–0.91]), patient education level (OR = 0.75 [95% CI, 0.03–1.47]), whether the patient was currently receiving anti-cancer treatment (OR = 0.79 [95% CI, 0.18–1.40]), and different core complaints for the appointment (OR = 0.55 [95% CI, 0.19–0.91]). Conclusion Our work describes the status of the content and duration of doctor–patient communication in oncological follow-up clinics in public hospitals in China. Patients had a single need for clinic visits, especially those attending a follow-up after discharge. Physicians spent as much time dealing with reimbursement issues as they spent on routine follow-up visits. Complaints of symptom distress were rare, and the reason for this needs to be investigated further. While oncology outpatient physicians in China have a heavy workload, patients' needs should be given sufficient attention.