Is fast access to general practice all that should matter? A discrete choice experiment of patients' preferences

Gerard, K; Salisbury, C; Street, D; Pope, C; Baxter, H

Is fast access to general practice all that should matter? A discrete choice experiment of patients' preferences

Gerard, K Salisbury, C

Street, D

Pope, C

Baxter, H

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Publication Type:: Journal Article
Citation:: Journal of Health Services Research and Policy, 2008, 13 (SUPPL. 2), pp. 3 - 10
Issue Date:: 2008-04-01

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Field	Value	Language
dc.contributor.author	Gerard, K	en_US
dc.contributor.author	Salisbury, C https://orcid.org/0000-0002-4378-3960	en_US
dc.contributor.author	Street, D https://orcid.org/0000-0002-4476-0656	en_US
dc.contributor.author	Pope, C https://orcid.org/0000-0002-8935-6702	en_US
dc.contributor.author	Baxter, H	en_US
dc.date.issued	2008-04-01	en_US
dc.identifier.citation	Journal of Health Services Research and Policy, 2008, 13 (SUPPL. 2), pp. 3 - 10	en_US
dc.identifier.issn	1355-8196	en_US
dc.identifier.uri	http://hdl.handle.net/10453/9754
dc.description.abstract	Objectives: To determine the relative importance of factors that influence patient choice in the booking of general practice appointments for two health problems. Methods: Two discrete choice experiments incorporated into a survey of general practice patients and qualitative methods to support survey development. Results: An overall response of 94% (1052/1123) was achieved. Factors influencing the average respondent's choice of appointment, in order of importance, were: seeing a doctor of choice; booking at a convenient time of day; seeing any available doctor; and having an appointment sooner rather than later (acute, low worry condition). This finding was the same for an ongoing, high worry condition but in addition the duration of the appointment was also of (small) value. Patients traded off speed of access for more convenient appointment times (a willingness to wait an extra 2.5-3 days longer to get a convenient time slot for an acute low worry/ongoing, high worry condition, respectively). However, contrary to expectation, patients were willing to trade off speed of access for continuity of care (e.g. willingness to wait five days longer to see the doctor of their choice for an acute, low worry condition). Preferences varied by a person's gender, work and carer status. Conclusions: Patients hold strong preferences for the way general practice appointment systems are managed. Contrary to current policy on improving access to primary care patients value a more complex mix of factors than fast access at all costs. It is important that policy-makers and practices take note of these preferences. © The Royal Society of Medicine Press Ltd 2008.	en_US
dc.relation.ispartof	Journal of Health Services Research and Policy	en_US
dc.relation.isbasedon	10.1258/jhsrp.2007.007087	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Health Care Surveys	en_US
dc.subject.mesh	Choice Behavior	en_US
dc.subject.mesh	Family Practice	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Patient Satisfaction	en_US
dc.subject.mesh	Health Services Accessibility	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Is fast access to general practice all that should matter? A discrete choice experiment of patients' preferences	en_US
dc.type	Journal Article
utslib.citation.volume	SUPPL. 2	en_US
utslib.citation.volume	13	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1402 Applied Economics	en_US
dc.location.activity	Sheffield, ENGLAND
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	SUPPL. 2	en_US
pubs.publication-status	Published	en_US
pubs.volume	13	en_US

Abstract:

Objectives: To determine the relative importance of factors that influence patient choice in the booking of general practice appointments for two health problems. Methods: Two discrete choice experiments incorporated into a survey of general practice patients and qualitative methods to support survey development. Results: An overall response of 94% (1052/1123) was achieved. Factors influencing the average respondent's choice of appointment, in order of importance, were: seeing a doctor of choice; booking at a convenient time of day; seeing any available doctor; and having an appointment sooner rather than later (acute, low worry condition). This finding was the same for an ongoing, high worry condition but in addition the duration of the appointment was also of (small) value. Patients traded off speed of access for more convenient appointment times (a willingness to wait an extra 2.5-3 days longer to get a convenient time slot for an acute low worry/ongoing, high worry condition, respectively). However, contrary to expectation, patients were willing to trade off speed of access for continuity of care (e.g. willingness to wait five days longer to see the doctor of their choice for an acute, low worry condition). Preferences varied by a person's gender, work and carer status. Conclusions: Patients hold strong preferences for the way general practice appointment systems are managed. Contrary to current policy on improving access to primary care patients value a more complex mix of factors than fast access at all costs. It is important that policy-makers and practices take note of these preferences. © The Royal Society of Medicine Press Ltd 2008.

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http://hdl.handle.net/10453/9754