Do patients value continuity of care in general practice? An investigation using stated preference discrete choice experiments

J Health Serv Res Policy. 2007 Jul;12(3):132-7. doi: 10.1258/135581907781543021.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Continuity of Patient Care / standards
  • Continuity of Patient Care / statistics & numerical data*
  • Family Practice / standards*
  • Female
  • Health Care Surveys
  • Health Services Accessibility / standards
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data*
  • Primary Health Care / standards*
  • Quality Indicators, Health Care
  • State Medicine
  • Surveys and Questionnaires
  • United Kingdom