Efficiency was further decomposed into productivity indicators - on the production per unit of input (for example, consultations per GP) -, and on the costs incurred to produce that amount (for example, total costs for delivering those consultations).
The costs for individuals with no previous consultations were €387 (95% CI €197 to 651) and €625 (95% CI €410 to 937) for those with consultations before the index visit (p = 0.19 between groups).
The discrepancies between the self-reported prevalence rates in the literature and those for consultations within the primary care record, suggest that there may be conflicting priorities between patients and health care professionals, and that database studies, are useful in only identifying the 'tip of the iceberg'.
The difference in giving the best-possible grades for the consultation between those who had a specific doctor appointed to them and those who did not varied from 7 to 10 percentage points and was statistically significant (P<0.001) in all quality aspects (Table 3).
For formal consultations (those where expected effects are significant), 82% of projects would be placed in a long bin, with an average time investment of 15 days.
This was related to duration of symptoms: those whose symptoms had lasted for less than 1 year before diagnosis consulted GPs on average 4.5 times for symptom related consultations, whereas those whose symptoms had lasted for 20 or more years had consulted their GP on average 27.7 times for symptom related consultations.
While the focus here is on palliative chemotherapy, this finding has implications for other consultations, particularly those involving difficult treatment decisions.
Although the intervention might potentially have benefit for all consultations (including those in primary care), the benefit is likely to be greater in secondary care where typically more issues and problems are discussed.
The data for those undergoing telephone consultation follow-up in this study was collected prospectively and compared with historical records of patients seen traditionally in the outpatient department.
