A real-time measurement of general practice workload in the Republic of Ireland: a prospective study

Brendan Crosbie; Michael Edmund O’Callaghan; Stuart O’Flanagan; David Brennan; Gavin Keane; William Behan

doi:10.3399/bjgp20X710429

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Figure 1.
Flow chart demonstrating sample size following the application of exclusion criteria.
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Figure 2.
Boxplot demonstrating the breakdown of daily activity according to work-type categories for the total population. CME = Continuous Medical Education.

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How this fits in

GP workload is an issue of increasing concern. This study attempted to accurately measure this workload among GPs in the Republic of Ireland (RoI). The use of a real-time recording method aims to address the limitations of survey-based approaches for measuring workload activity. Data were recorded over a 6-week period with the results providing a comprehensive quantification of daily GP workload activity that, to the authors’ knowledge, has not been previously achieved elsewhere. The results have the potential to inform future planning and delivery of general practice in the RoI. This study also demonstrates an efficient and accurate method of capturing workload activity that could be employed in future measurements of workload.

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Table 1.

Characteristics of the sample population, N = 123

Characteristic	Partner (%)	Assistant (%)	Registrar (%)	Urban (%)	Mixed (%)	Rural (%)
Sex
Male	44 (52.4)	9 (50.0)	7 (33.3)	34 (47.2)	11 (44.0)	15 (57.7)
Female	40 (47.6)	9 (50.0)	14 (66.7)	38 (52.8)	14 (56.0)	11 (42.3)

Age, years
<45	16 (19.0)	15 (83.3)	21 (100)	29 (40.3)	9 (36.0)	14 (53.8)
45–54	35 (41.7)	3 (16.7)	0 (0)	23 (31.9)	8 (32.0)	7 (26.9)
≥55	33 (39.3)	0 (0)	0 (0)	20 (27.8)	8 (32.0)	5 (19.2)

Location
Urban	47 (56.0)	12 (66.7)	13 (61.9)	72 (58.5)	—	—
Mixed	21 (25.0)	2 (11.1)	2 (9.5)	—	25 (20.3)	—
Rural	16 (19.0)	4 (22.2)	6 (28.6)	—	—	26 (21.1)

Role
Partner	84 (68.3)	—	—	—	—	—
Assistant	—	18 (14.6)	—	—	—	—
Registrar	—	—	21 (17.1)	—	—	—

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Table 2.

Time spent completing 10 sessions and the proportional time expenditure on different working activities

Demographic	N	Total time, mean hours, %	Clinical consultation, hours (%)	Clinical paperwork, hours (%)	Telephone call, hours (%)	Prescription, hours (%)	House call, hours (%)	CME/research, hours (%)	Administrative work, hours (%)
Total Sample	123	49.4	31.64 (64.0)	8.36 (16.9)	2.20 (4.5)	1.73 (3.5)	1.43 (2.9)	1.52 (3.1)	2.52 (5.1)

Role
Partner	84	50.8	31.77 (62.5)	8.50 (16.7)	2.39 (4.7)	1.71 (3.4)	1.63 (3.2)	1.61 (3.2)	3.21 (6.3)
Assistant	18	47.5	33.97 (71.5)	6.61 (13.9)	1.51 (3.2)	1.64 (3.5)	1.36 (2.9)	0.95 (2.0)	1.47 (3.1)
Registrar	21	45.4	29.13 (64.2)	9.31 (20.5)	2.02 (4.4)	1.88 (4.1)	0.71 (1.6)	1.67 (3.7)	0.68 (1.5)

Location
Urban	72	49.6	31.56 (63.6)	8.95 (18.0)	2.08 (4.2)	1.82 (3.7)	1.22 (2.5)	1.30 (2.6)	2.67 (5.4)
Mixed	25	49.8	33.28 (66.8)	7.12 (14.3)	1.97 (4.0)	1.57 (3.2)	1.61 (3.2)	1.90 (3.8)	2.35 (4.7)
Rural	26	48.5	30.29 (62.4)	7.93 (16.3)	2.73 (5.6)	1.63 (3.4)	1.87 (3.9)	1.77 (3.6)	2.29 (4.7)

Age, years
<45	52	47.7	32.24 (67.6)	7.91 (16.6)	1.90 (4.0)	1.48 (3.1)	0.90 (1.9)	1.30 (2.7)	1.94 (4.1)
45–54	38	50.6	30.42 (60.1)	8.78 (17.3)	2.51 (5.0)	2.07 (4.1)	1.51 (3.0)	1.95 (3.9)	3.39 (6.7)
≥55	33	50.8	32.11 (63.3)	8.60 (16.9)	2.31 (4.6)	1.73 (3.4)	2.18 (4.3)	1.38 (2.7)	2.45 (4.8)

Sex
Male	60	49.4	31.60 (64.0)	7.53 (15.2)	2.17 (4.4)	1.65 (3.3)	2.05 (4.1)	1.66 (3.4)	2.75 (5.6)
Female	63	49.4	31.69 (64.1)	9.16 (18.5)	2.22 (4.5)	1.81 (3.7)	0.84 (1.7)	1.39 (2.8)	2.30 (4.7)

CME = Continuous Medical Education.

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Table 3.

Recording start and finish times of the total number of days recorded

Demographic	N	Recorded start time, %			Recorded finishing time, %

		<9.00 am	<8.00 am	<7.00 am	>5.00 pm	>6.00 pm	>7.00 pm	>8.00 pm	>9.00 pm	>10.00 pm	>11.00 pm
Total Sample	1109	52.6	10.5	1.9	72.7	33.8	18.7	7.9	7.0	5.1	3.8

Role
Partner	815	57.5	11.7	2.5	73.6	60.9	35.9	20.8	13.9	7.9	3.5
Assistant	134	33.3	4.8	0.0	66.3	40.3	16.9	8.2	6.4	3.9	1.2
Registrar	160	43.1	9.0	0.0	69.3	37.1	14.3	6.5	4.0	0.4	0.0

Location
Urban	642	49.7	11.3	1.5	71.8	54.2	30.7	17.6	10.8	5.6	2.2
Mixed	209	52.1	7.4	2.6	73.5	54.1	28.3	11.8	8.6	3.8	2.4
Rural	258	60.6	10.8	2.5	71.8	57.6	32.5	20.2	15.1	10.0	4.0

Age, years
<45	345	48.3	9.1	0.9	71.1	46.0	20.2	10.9	7.6	4.5	2.6
45–54	342	56.5	15.2	3.6	73.4	60.0	39.9	22.3	15.2	8.3	3.1
≥55	422	53.7	7.4	1.4	71.9	60.3	32.6	18.6	12.0	6.5	2.5

Sex
Male	570	52.6	8.3	2.5	74.5	59.7	33.0	19.0	12.4	7.4	3.4
Female	539	52.7	12.8	1.3	69.7	49.8	27.8	14.8	10.2	5.2	1.9

Supplementary Data

SUPPLEMENTARY DATA

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