Evidence map›Paper›PMID 41888705›Full record

ArticleBMC primary care2026

Timeliness, continuity or travel time: results of a choice-based analysis exploring public preferences for access to primary care in Canada.

Tara Kiran, Maryam Daneshvarfard, Alexander Beyer, Danielle Martin, Mylaine Breton, Rita K McCracken, M Ruth Lavergne, Neb Kovacina, Alan Katz, Andrew D Pinto and 3 more

Abstract read
In one paragraph

Article in BMC primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Tara KiranDepartment of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. tara.kiran@utoronto.ca.ORCID 0000-0002-2520-112X
Maryam DaneshvarfardMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Alexander BeyerDepartment of Political Science, McMaster University, Hamilton, Ontario, Canada.
Danielle MartinDepartment of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Mylaine BretonDepartment of Community Health, Université de Sherbrooke, Longueuil, Québec, Canada.
Rita K McCrackenDepartment of Family Practice, University of British Columbia, Vancouver, Canada.
M Ruth LavergneDepartment of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Neb KovacinaDepartment of Family Medicine, McGill University, Montreal, Quebec, Canada.
Alan KatzDepartments of Family Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Andrew D PintoDepartment of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Jasmin KayMASS LBP, Toronto, Ontario, Canada.
Peter MacLeodMASS LBP, Toronto, Ontario, Canada.
Clifton van der LindenDepartment of Political Science, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccess and continuity are two pillars of primary care that are often in tension. While both are important to patients, it is unclear which they prioritize. This study examines public preferences for timeliness, continuity, and travel time to primary care in Canada using a discrete choice experiment.

methodsThe experiment was embedded in a national online survey of adults in Canada. Respondents were randomly assigned to one of four clinical scenarios (worsening depression, new sore throat, new sexually transmitted infection, or worsening diabetes) and completed a discrete choice experiment selecting between two hypothetical primary care options. Each option varied in timeliness (same/next day, 2–7 days, 1 week–1 month), continuity (regular provider, unknown provider with or without access to records), and travel time (≤ 10 min, 10–30 min, > 30 min). We estimated marginal means (MM) to assess attribute preferences and conducted stratified analyses by socio-demographic characteristics. Responses were weighted to be demographically representative of the Canadian population.

resultsWe analyzed data from 9276 survey respondents. All three primary care attributes significantly impacted decision-making, with timeliness and continuity being more important for decision-making than travel time. For example, for depression, 75% of participants (95% CI 73%-77%) opted for healthcare options that offered the quickest appointment, 66% (95% CI 64%-68%) opted for care with their regular clinician, and 56% (95% CI 54%-58%) favored the shortest travel time less than 10 min. Including the third level of each care attribute in a healthcare option significantly reduced the likelihood of selecting that option. Preferences did not vary substantially by socio-demographic characteristics.

conclusionsBoth attributes of access and continuity were consistently prioritized by respondents, with preferences remaining stable across respondent characteristics. Our findings highlight the need for care models that offer timely access with familiar clinicians, or alternatives that maintain informational continuity.

Indexed as

Continuity of Patient CareHealth Services AccessibilityPatient PreferencePrimary Health CareAccess to Primary CareAdolescentAdultAgedCanadaChoice BehaviorFemaleHumansMaleMiddle AgedSurveys and QuestionnairesTime FactorsChoice behaviorContinuity of patient careDiscrete choice experimentHealth care reformHealth services accessibilityInformational continuityPatient-centered carePatient preferencePrimary health careRelational continuity

Identifiers

PMID41888705
PMCPMC13147695

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.