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  • Title: Do patients value continuity of care in general practice? An investigation using stated preference discrete choice experiments.
    Author: Turner D, Tarrant C, Windridge K, Bryan S, Boulton M, Freeman G, Baker R.
    Journal: J Health Serv Res Policy; 2007 Jul; 12(3):132-7. PubMed ID: 17716414.
    Abstract:
    OBJECTIVES: To estimate the relative importance to patients of continuity of care compared with other aspects of a primary care consultation. METHODS: We carried out a discrete choice experiment in Leicestershire and London on a stratified random sample of 646 community dwelling adults taken from general practitioner (GP) registers, plus 20 interviews with Punjabi, Urdu and Gujarati speakers. The attributes examined were: the type of professional consulted, relational continuity, informational continuity and access. RESULTS: Individuals' values changed according to their reason for making a primary care consultation. If consulting for minor familiar symptoms, individuals would be prepared to trade off one extra day's wait to see a GP rather than a nurse, 0.9 days for relational continuity, and 1.6 days for informational continuity. If consulting for a new condition they were uncertain about, they would be prepared to trade off an additional wait of 3.5 days to see a GP rather than a nurse, 2.4 days for relational continuity and 3.9 days for informational continuity. For a routine check-up, an individual would be prepared to trade off an additional wait of 3.5 days to see a GP rather than a nurse, 4.2 days for relational continuity and 7.8 days for informational continuity. CONCLUSIONS: Respondents stated their preference to wait longer to see a familar medical practitioner who was well informed about their case when they had a problem causing uncertainty or needed a routine check-up. They preferred quick access for likely minor 'low impact' symptoms. Appointment systems in general practice should be sufficiently flexible to meet these different preferences.
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