Abstract
BackgroundPrimary care is a key element of health care systems and addresses the main health problems of the population. Due to the demographic change, primary care even gains in importance. The knowledge of the patients’ preferences can help policy makers as well as physicians to set priorities in their effort to make health care delivery more responsive to patients’ needs. Our objective was to describe which aspects of primary care were included in preference studies and which of them were the most preferred aspects.MethodsIn order to elicit the preferences for primary care, a systematic literature search was conducted. Two researchers searched three electronic databases (PubMed, Scopus, and PsycINFO) and conducted a narrative synthesis. Inclusion criteria were: focus on primary health care delivery, discrete choice experiment as elicitation method, and studies published between 2006 and 2015 in English language.ResultsWe identified 18 studies that elicited either the patients’ or the population’s preferences for primary care based on a discrete choice experiment. Altogether the studies used 16 structure attributes, ten process attributes and four outcome attributes. The most commonly applied structure attribute was “Waiting time till appointment”, the most frequently used process attribute was “Shared decision making / professional’s attention paid to your views”. “Receiving the ‘best’ treatment” was the most commonly applied outcome attribute. Process attributes were most often the ones of highest importance for patients or the population. The attributes and attribute levels used in the discrete choice experiments were identified by literature research, qualitative research, expert interviews, or the analysis of policy documents.ConclusionsThe results of the DCE studies show different preferences for primary health care. The diversity of the results may have several reasons, such as the method of analysis, the selection procedure of the attributes and their levels or the specific research question of the study. As the results of discrete choice experiments depend on many different factors, it is important for a better comprehensibility of the studies to transparently report the steps undertaken in a study as well as the interim results regarding the identification of attributes and levels.
Highlights
Primary care is a key element of health care systems and addresses the main health problems of the population
According to the World Health Organization’s (WHO’s) declaration of Alma-Ata, primary care is a key element of health care systems
As many countries face a shortage of general practitioners (GPs) in rural and remote areas, the maintenance of an adequate primary care provision is a central task of health care systems and a highly important subject for health policies
Summary
Primary care is a key element of health care systems and addresses the main health problems of the population. According to the World Health Organization’s (WHO’s) declaration of Alma-Ata, primary care is a key element of health care systems As it addresses the main health problems in the community and often serves as the patients’ first level of contact with the health care system, primary care is highly important to all citizens [1]. If the reorganization does not take into account the patients’ needs and preferences, patients probably would not use them and continue visiting emergency rooms. It is of high relevance for the future organization of primary care and the introduction of new models of care to know the population’s preferences for different aspects of primary care
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