title: Do patients value continuity of care in general practice? An investigation using stated preference discrete choice experiments.
abstract: OBJECTIVE
  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.
authors: Wessex Institute for Health Research and Development, University of Southampton, Southampton, UK. D.Turner@soton.ac.uk
authors: David
authors: D
authors: Turner
authors: Carolyn
authors: C
authors: Tarrant
authors: Kate
authors: K
authors: Windridge
authors: Stirling
authors: S
authors: Bryan
authors: Mary
authors: M
authors: Boulton
authors: George
authors: G
authors: Freeman
authors: Richard
authors: R
authors: Baker
mesh_terms: D000328:Adult; D000368:Aged; D003266:Continuity of Patient Care / Q000592:standards / Q000706:statistics & numerical data*; D005194:Family Practice / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom