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Eliciting preferences of the community for out of hours care provided by general practitioners: a stated preference discrete choice experiment

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  • Scott, Anthony
  • Watson, M. Stuart
  • Ross, Sue
Abstract
Access to primary care services is a major issue as new models of delivering primary care continue develop in many countries. Major changes to out of hours care provided by general practitioners (GPs) were made in the UK in 1995. These were designed in response to low morale and job dissatisfaction of GPs, rather than in response to patients' preferences. The aim of this study is to elicit the preferences of patients and the community for different models of GP out of hours care. A questionnaire was sent to parents of children in Aberdeen and Glasgow in Scotland who had received a home visit or attended a primary care emergency centre, or were registered with a GP. The questionnaire used a discrete choice experiment that asked parents to imagine their child had respiratory symptoms. Parents were then asked to choose between a series of pairs of scenarios, with each scenario describing a different model of out of hours care. Each model varied by waiting time, who was seen, location, and whether the doctor listened. The response rate was 68% (3893/5718). The most important attribute was whether the doctor seemed to listen, suggesting that policies aimed at improving doctor-patient communication will lead to the largest improvements in utility. The most preferred location of care was a hospital accident and emergency department. This suggests that new models of primary care emergency centres may not reduce the demand for accident and emergency visits from this group of patients in urban areas. Preferences also differed across sub-groups of patients. Those who had never used out of hours care before had stronger preferences for waiting time and the doctor listening, suggesting higher expectations of non-users. Further research is required into the demand for out of hours care as new models of care become established.

Suggested Citation

  • Scott, Anthony & Watson, M. Stuart & Ross, Sue, 2003. "Eliciting preferences of the community for out of hours care provided by general practitioners: a stated preference discrete choice experiment," Social Science & Medicine, Elsevier, vol. 56(4), pages 803-814, February.
    • Handle: RePEc:eee:socmed:v:56:y:2003:i:4:p:803-814
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    Citations

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    Cited by:

    1. Chiara Seghieri & Alessandro Mengoni & Sabina Nuti, 2014. "Applying discrete choice modelling in a priority setting: an investigation of public preferences for primary care models," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(7), pages 773-785, September.
    2. Charles Cunningham & Ken Deal & Heather Rimas & Heather Campbell & Ann Russell & Jennifer Henderson & Anne Matheson & Blake Melnick, 2008. "Using Conjoint Analysis to Model the Preferences of Different Patient Segments for Attributes of Patient-Centered Care," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 1(4), pages 317-330, October.
    3. Scott, Anthony & Witt, Julia, 2020. "Loss aversion, reference dependence and diminishing sensitivity in choice experiments," Journal of choice modelling, Elsevier, vol. 37(C).
    4. Paul Hodgkins & Paul Swinburn & Dory Solomon & Linnette Yen & Sarah Dewilde & Andrew Lloyd, 2012. "Patient Preferences for First-Line Oral Treatment for Mild-to-Moderate Ulcerative Colitis," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 5(1), pages 33-44, March.
    5. Nan Liu & Stacey R. Finkelstein & Margaret E. Kruk & David Rosenthal, 2018. "When Waiting to See a Doctor Is Less Irritating: Understanding Patient Preferences and Choice Behavior in Appointment Scheduling," Management Science, INFORMS, vol. 64(5), pages 1975-1996, May.
    6. Emma L Giles & Frauke Becker & Laura Ternent & Falko F Sniehotta & Elaine McColl & Jean Adams, 2016. "Acceptability of Financial Incentives for Health Behaviours: A Discrete Choice Experiment," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-19, June.
    7. Angela Robinson & Anne Spencer & Peter Moffatt, 2015. "A Framework for Estimating Health State Utility Values within a Discrete Choice Experiment," Medical Decision Making, , vol. 35(3), pages 341-350, April.
    8. Megha Swami & Hugh Gravelle & Anthony Scott & Jenny Williams, 2018. "Hours worked by general practitioners and waiting times for primary care," Health Economics, John Wiley & Sons, Ltd., vol. 27(10), pages 1513-1532, October.
    9. Lieke Boonen & Frederik Schut & Bas Donkers & Xander Koolman, 2009. "Which preferred providers are really preferred? Effectiveness of insurers’ channeling incentives on pharmacy choice," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 347-366, December.
    10. Emily Lancsar & Cam Donaldson, 2005. "Discrete choice experiments in health economics: Distinguishing between the method and its application," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(4), pages 314-316, December.
    11. Deng, Yewen & Li, Na & Jiang, Zhibin & Xie, Xiaoqing & Kong, Nan, 2021. "Optimal differential subsidy policy design for a workload-imbalanced outpatient care network," Omega, Elsevier, vol. 99(C).
    12. Scott, Anthony, 2002. "Identifying and analysing dominant preferences in discrete choice experiments: An application in health care," Journal of Economic Psychology, Elsevier, vol. 23(3), pages 383-398, June.
    13. Patricia Kenny & Stephen Goodall & Deborah J. Street & Jessica Greene, 2017. "Choosing a Doctor: Does Presentation Format Affect the Way Consumers Use Health Care Performance Information?," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 10(6), pages 739-751, December.
    14. Kara Hanson & Barbara McPake & Pamela Nakamba & Luke Archard, 2005. "Preferences for hospital quality in Zambia: results from a discrete choice experiment," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 687-701, July.
    15. Lagarde, Mylene & Erens, Bob & Mays, Nicholas, 2015. "Determinants of the choice of GP practice registration in England: Evidence from a discrete choice experiment," Health Policy, Elsevier, vol. 119(4), pages 427-436.
    16. Foster, Michele M. & Earl, Peter E. & Haines, Terry P. & Mitchell, Geoffrey K., 2010. "Unravelling the concept of consumer preference: Implications for health policy and optimal planning in primary care," Health Policy, Elsevier, vol. 97(2-3), pages 105-112, October.
    17. Philips, Hilde & Mahr, Dominik & Remmen, Roy & Weverbergh, Marcel & De Graeve, Diana & Van Royen, Paul, 2012. "Predicting the place of out-of-hours care—A market simulation based on discrete choice analysis," Health Policy, Elsevier, vol. 106(3), pages 284-290.
    18. Mandy Ryan & Verity Watson & Vikki Entwistle, 2009. "Rationalising the ‘irrational’: a think aloud study of discrete choice experiment responses," Health Economics, John Wiley & Sons, Ltd., vol. 18(3), pages 321-336, March.

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