Relational continuity or rapid accessibility in primary care? A mixed-methods study of veteran preferences

Sara M. Locatelli*, Jennifer N. Hill, Mary E. Talbot, Gordon Schectman, Sherri L. Lavela

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

OBJECTIVE:: To examine preferences for relational continuity and rapid accessibility for telephone care. METHODS:: A mixed-methods sequential explanatory design was utilized. Structured telephone interviews were conducted with 448 Veterans receiving primary care from Veterans Affairs facilities, who rated the importance of relational continuity and rapid accessibility. Seventeen focus groups were conducted with 123 Veterans to examine preferences for continuity versus accessibility and factors affecting these preferences. RESULTS:: Higher proportions of interview patients rated talking with a nurse from their own primary care team (69%) and talking with a nurse with whom they have previous primary care contact (60%) as very important, compared with talking to any nurse as soon as possible (53%) and receiving advice immediately (50%). Focus group participants preferred a familiar provider within 24 hours over immediate contact with an unfamiliar provider, particularly for routine needs. Rapid accessibility was more frequently preferred for urgent questions/concerns. Preference for relational continuity was mitigated by patient age, and access to electronic medical records in larger, but not smaller, facilities. CONCLUSIONS:: Health care systems supplementing in-person care with telephone care need to ensure that this care aligns with patient preferences and provide opportunities for both relational continuity and rapid accessibility where possible.

Original languageEnglish (US)
Pages (from-to)76-85
Number of pages10
JournalQuality management in health care
Volume23
Issue number2
DOIs
StatePublished - Jan 1 2014

Keywords

  • continuity of patient care
  • health services accessibility
  • patient preference
  • primary health care
  • telemedicine

ASJC Scopus subject areas

  • Leadership and Management
  • Health(social science)
  • Health Policy
  • Care Planning

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