Consultations with doctors

Consultations with doctors are an important measure of overall access to health services, since most diseases can be managed effectively in primary care without hospitalisation, and a doctor consultation often precedes a hospital admission.

Generally, the annual number of doctor consultations per person in Asia-Pacific is lower than the OECD average of 6.7, but there are some cross-country variations (Figure 5.4). The doctor consultation rate ranges from above ten per person in the Republic of Korea, Japan and Hong Kong, China to less than one per person in Bangladesh and Cambodia. In general, consultation rates tend to be highest in the high-income countries and territories in the region (except Singapore) and significantly lower in low-income countries, suggesting that income levels have some impact on populations’ health care-seeking behaviours. It should be noted that in low-income countries most primary contacts are with medical assistants, clinical officers or nurses, and not with doctors.

Mainly reflecting the limited supply of doctors (see indicator “Doctors and nurses” in Chapter 5), the number of consultations per doctor is – in most Asia-Pacific countries – higher that the OECD average at 2 144 per year, but there is a large cross-country variation (Figure 5.5). Doctors had more than 6 000 consultations on average in the Republic of Korea, Sri Lanka, Thailand and Hong Kong, China in a year, while a doctor in Bangladesh, Mongolia, and Viet Nam generally delivers less than 2 000 consultations per year.

The number of consultations per doctor should not be taken as a measure of productivity as consultations can vary in length and effectiveness, and doctors also undertake work devoted to inpatients, administration and research. This measure is also subject to comparability limitations such as the exclusion of doctors working in the private sector or the inclusion of other health professionals providing primary care in some countries (see box below on “Definition and comparability”).

There is a close relationship between doctor consultation rates – a proxy for access to services – and healthy life expectancy at birth, with consultation rates being highest in countries reporting the highest healthy life expectancy (Figure 5.6). This simple correlation, however, does not necessarily imply causality since overall living standards may influence both consultation rates and life expectancy. There are also country examples such as Mongolia (Singapore) where healthy life expectancy is much lower (higher) than expected based on consultation rates, indicating that other factors, such as geographical accessibility and income level, affect life expectancy.

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