title: Accessing primary care: a simulated patient study.
abstract: BACKGROUND
  Simulated patient, or so-called 'mystery-shopper', studies are a controversial, but potentially useful, approach to take when conducting health services research.
  
  
  OBJECTIVE
  To investigate the construct validity of survey questions relating to access to primary care included in the English GP Patient Survey.
  
  
  METHODS
  Observational study in 41 general practices in rural, urban, and inner-city settings in the UK.
  
  
  METHODS
  Between May 2010 and March 2011, researchers telephoned practices at monthly intervals, simulating patients requesting routine, but prompt, appointments. Seven measures of access and appointment availability, measured from the mystery-shopper contacts, were related to seven measures of practice performance from the GP Patient Survey.
  
  
  RESULTS
  Practices with lower access scores in the GP Patient Survey had poorer access and appointment availability for five out of seven items measured directly, when compared with practices that had higher scores. Scores on items from the national survey that related to appointment availability were significantly associated with direct measures of appointment availability. Patient-satisfaction levels and the likelihood that patients would recommend their practice were related to the availability of appointments. Patients' reports of ease of telephone access in the national survey were unrelated to three out of four measures of practice call handling, but were related to the time taken to resolve an appointment request, suggesting responders' possible confusion in answering this question.
  
  
  CONCLUSIONS
  Items relating to the accessibility of care in a the English GP patient survey have construct validity. Patients' satisfaction with their practice is not related to practice call handling, but is related to appointment availability.
authors.affiliation: University of Exeter Medical School, Exeter, UK. jlcampbell@pms.ac.uk
authors.forename: John L
authors.initials: JL
authors.lastname: Campbell
authors.forename: Mary
authors.initials: M
authors.lastname: Carter
authors.forename: Antoinette
authors.initials: A
authors.lastname: Davey
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Roberts
authors.forename: Marc N
authors.initials: MN
authors.lastname: Elliott
authors.forename: Martin
authors.initials: M
authors.lastname: Roland
mesh_terms: D001071:Appointments and Schedules; D004739:England; D058006:General Practice / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D015277:Hotlines / Q000706:statistics & numerical data; D006801:Humans; D017060:Patient Satisfaction; D016544:Patient Simulation; D012423:Rural Health / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data; D014850:Waiting Lists
references.citation: Br J Gen Pract. 2006 Oct;56(531):743-8
references.pmid: 17007703
references.citation: J Health Serv Res Policy. 2008 Apr;13(2):67-72
references.pmid: 18416910
references.citation: JAMA. 2003 Feb 26;289(8):1035-40
references.pmid: 12597760
references.citation: N Engl J Med. 2011 Aug 11;365(6):484-6
references.pmid: 21793739
references.citation: BMJ. 2003 Nov 22;327(7425):1219-21
references.pmid: 14630762
references.citation: Fam Pract. 2006 Apr;23(2):233-9
references.pmid: 16364952
references.citation: Br J Gen Pract. 2007 Aug;57(541):615-21
references.pmid: 17688755
references.citation: Br J Gen Pract. 2007 Aug;57(541):608-14
references.pmid: 17688754
references.citation: N Engl J Med. 2011 Jun 16;364(24):2324-33
references.pmid: 21675891
references.citation: JAMA. 2005 Sep 14;294(10):1248-54
references.pmid: 16160133
references.citation: J Health Serv Res Policy. 2008 Apr;13 Suppl 2:3-10
references.pmid: 18416923
references.citation: N Engl J Med. 1994 May 19;330(20):1426-30
references.pmid: 8159198
references.citation: Ann Fam Med. 2008 Mar-Apr;6(2):107-15
references.pmid: 18332402
references.citation: Psychol Bull. 1992 Jul;112(1):155-9
references.pmid: 19565683
references.citation: Med Care. 2011 Aug;49(8):724-33
references.pmid: 21610543