Comparison of patients' preferences and evaluations regarding aspects of general practice care

BACKGROUND: Although patients' views on health care are perceived to be crucial, insight into the different constructs capturing these views remains limited. OBJECTIVE: The aim of this study was to determine the relationship between patients' preferences and their evaluations of general practice care. METHODS: Patients visiting five rural practices in The Netherlands were asked to complete a questionnaire measuring either their evaluations or their preferences on 44 aspects of general practice care. After at least 3 weeks, those patients who had answered the evaluation questionnaire received the questionnaire measuring their preferences, and vice versa. RESULTS: A total of 449 patients answered both questionnaires (response 70%). The longer the period after the consultation, the lower was the mean percentage of all 44 aspects rated as 'good' in the evaluation questionnaire (P = 0.006) and the higher was the mean percentage of all 44 aspects rated as 'very important' in the preference questionnaire (P = 0.046). The Spearman rank order correlation between the ranking of patients' evaluations and patients' preferences was 0.34, a low although significant correlation (P = 0.024), i.e. the two rank orders do not resemble each other very much. CONCLUSIONS: Patients clearly distinguished their preferences from their evaluations of general practice care. Aspects of general practice care, whether important or not, can be evaluated positively or negatively. Patients' preferences and patients' evaluations are, however, both influenced by the length of the time elapsed since the consultation.