What are the key attributes of primary care for patients? Building a conceptual ‘map’ of patient preferences

BACKGROUND: Responding to the preferences of patients is a key focus of current health policy and is especially important in primary care. Responding effectively to patient preferences requires a clear understanding of the way in which patients assess primary care services. OBJECTIVE: This study was designed to provide a 'map' of the content and structure of the key attributes of patient preferences concerning primary care. DESIGN: The development of the 'map' used secondary research methods. Electronic databases were searched for published conceptual reviews of patient preferences, which were used to develop a basic 'map' through content analysis. A search for recently published primary empirical studies of patient preferences was conducted to extend and develop the 'map'. The 'map' was tested by taking a random sample of patient assessment instruments and categorizing the item content. RESULTS: Seven major categories and multiple subcategories were described. The major categories were access, technical care, interpersonal care, patient-centredness, continuity, outcomes, and hotel aspects of care. The coverage of these attributes in a selection of patient assessment instruments varied widely, and the coding of a proportion of items in the patient assessment instruments according to the 'map' was problematic. CONCLUSIONS: The conceptual 'map' can be used to plan comprehensive assessment of patient preferences in primary care. It also raises many theoretical issues concerning the nature of attributes and their interrelationships. The implications for the measurement of patient preferences are discussed.