title: Exploring preferences for symptom management in primary care: a discrete choice experiment using a questionnaire survey.
abstract: BACKGROUND
  Symptoms are important drivers for the use of primary care services. Strategies aimed at shifting the focus away from the GP have broadened the range of primary healthcare available.
  
  
  OBJECTIVE
  To explore preferences for managing symptoms and investigate trade-offs that the public are willing to make when deciding between different primary care services.
  
  
  METHODS
  UK-wide postal questionnaire survey of 1370 adults.
  
  
  METHODS
  A discrete choice experiment examined management preferences for three symptoms of differing seriousness (diarrhoea, dizziness, and chest pain). Willingness-to-pay estimates compared preferences between symptoms, and by sex, age, and income.
  
  
  RESULTS
  Preferences differed significantly between symptoms. 'Self-care' was the preferred action for diarrhoea and 'consulting a GP' for dizziness and chest pain. 'Waiting time' and 'chance of a satisfactory outcome' were important factors for all three symptoms, although their relative importance differed. Broadly, people were more prepared to wait longer and less prepared to trade a good chance of a satisfactory outcome for symptoms rated as more serious. Generally, preferences within subgroups followed similar patterns as for the whole sample, although there were differences in the relative strength of preferences.
  
  
  CONCLUSIONS
  Despite increased choices in primary care, 'traditional' actions of 'self-care' for minor symptoms and 'GP consultation' for more serious symptoms were preferred. The present findings suggest, however, that people may be willing to trade between different health services, particularly for less serious symptoms. Understanding the relative importance of different factors may help inform interventions aimed at changing management behaviour or improving services.
authors.affiliation: Academic Primary Care.
authors.forename: Anne
authors.initials: A
authors.lastname: McAteer
authors.affiliation: Cicely Saunders Institute of Palliative Care and Rehabilitation, King's College London, London.
authors.forename: Deokhee
authors.initials: D
authors.lastname: Yi
authors.affiliation: Health Economics Research Unit, Division of Applied Health Sciences, University of Aberdeen, Aberdeen.
authors.forename: Verity
authors.initials: V
authors.lastname: Watson
authors.affiliation: Health Economics Research Unit, Division of Applied Health Sciences, University of Aberdeen, Aberdeen.
authors.forename: Patricia
authors.initials: P
authors.lastname: Norwood
authors.affiliation: Health Economics Research Unit, Division of Applied Health Sciences, University of Aberdeen, Aberdeen.
authors.forename: Mandy
authors.initials: M
authors.lastname: Ryan
authors.affiliation: NHS Grampian chair of primary care and vice principal, Academic Primary Care;
authors.forename: Philip C
authors.initials: PC
authors.lastname: Hannaford
authors.affiliation: Academic Primary Care;
authors.forename: Alison M
authors.initials: AM
authors.lastname: Elliott
mesh_terms: D000328:Adult; D019468:Disease Management; D005260:Female; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000592:standards*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: discrete choice experiment; health services research; primary health care; signs and symptoms; symptom management