ArticleBMJ open2019
Patient trade-offs between continuity and access in primary care interprofessional teaching clinics in Canada: a cross-sectional survey using discrete choice experiment.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Evolving Landscape of Discrete Choice Experiments in Health Economics: A Systematic Review.PharmacoEconomics · 2025Pooled it
- Access or continuity: a zero sum game? A systematic review of the literature examining the relationship between access and continuity in primary healthcare.BMC primary care · 2025Pooled it
- Continuity of care and patient-reported experiences in Norwegian general practice: are they linked, and does the measurement of continuity matter?Family practice · 2026Article
- Timeliness, continuity or travel time: results of a choice-based analysis exploring public preferences for access to primary care in Canada.BMC primary care · 2026Article
- Re-evaluating the access imperative in healthcare in the United States.Journal of public health policy · 2026Review
- What do patients and clinicians think about continuity in general practice in England? a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Assessing the Critical Thinking and Training Needs of Healthcare Professionals, and Patient Experiences: An Exploratory Cross-Sectional Study in Primary Care of Crete, Greece.Healthcare (Basel, Switzerland) · 2026Article
- Choosing a Primary Care Provider: A Formative Qualitative Study to Identify Patient Preferences.Journal of patient-centered research and reviews · 2026Article
- Re-Evaluating Access in Healthcare: Focus on Quality of Care.Public health challenges · 2025Review
- Social and health determinants of wait times for primary care in Canada.Canadian family physician Medecin de famille canadien · 2025Article
- Patient preferences for key organizational features of primary cardiovascular care in Quebec: a discrete choice experiment.BMC primary care · 2025Article
- Factors associated with patients' experience of accessibility to general practice: results from a national survey in Norway.BMC health services research · 2024Article
- Article
- Perceived Access and Appropriateness: Comparison of Teaching and Resident Family Physicians' Patients.Family medicine · 2023Article
- How do respondents of primary care surveys compare to typical users of primary care? A comparison of two surveys.BMC primary care · 2023Article
- Patient and Public Preferences for Coordinated Care in Switzerland: Development of a Discrete Choice Experiment.The patient · 2022Review
- Stated preferences for family doctor contract services: a survey of the rural elderly in Anhui Province, China.BMJ open · 2022Article
- Article
- Continuity in the academic family medicine teaching environment: Exploring the potential of the CFPC's Patient's Medical Home.Canadian family physician Medecin de famille canadien · 2022Article
- Identifying New Zealand Public Preferences for Pharmacist Prescribers in Primary Care: A Discrete Choice Experiment.The patient · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTimely access to care and continuity with a specific provider are important determinants of patient satisfaction when booking appointments in primary care settings. Advanced access booking systems restrict the majority of providers' appointment spots for same-day appointments and keep the number of prebooked appointments to a minimum. In the teaching clinic environment, continuity with the same provider can be a challenge. This study examines trade-offs that patients may consider during appointment bookings for six different clinical scenarios across a number of key access and continuity attributes using a discrete choice experiment (DCE) method.
designCross-sectional survey.
settingTwo urban family medicine teaching clinics in Canada.
participantsConvenience sample of 430 patients of family medicine clinics aged 18 and older.
interventionDiscrete choice conjoint experiment survey. PRIMARY OUTCOME MEASURES: Patient preferences on six attributes: appointment booking method, appointment wait time, time spent in the waiting room, appointment time convenience, familiarity with healthcare provider and position of healthcare provider. Data were analysed by hierarchical Bayes analysis to determine estimates of part-worth utilities for each respondent.
resultsPatients rated appointment wait time as the most highly valued attribute, followed by position of provider, then familiarity with the provider. Patients showed a significant preference (p<0.02) for their own physician for booking of routine annual check-ups and other logical preferences across attributes overall and by clinical scenario.
conclusionsPatients preferred timely access to their primary care team over other attributes in the majority of health state scenarios tested, especially urgent issues, however they were willing to wait for a check-up. These results support the notion that advanced access booking systems which leave the majority of appointment spots for same day access and still leave a few for continuity (check-up) bookings, align well with trends in patient preferences.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.