Download Full Text (110 KB)
Background: In some innovative outpatient practice models, patients are faced with trade-offs, such as choosing between continuity of care vs quick access to a healthcare practitioner (HCP). Our objective was to assess sex-based differences in visit access preferences at an academic outpatient internal medicine clinic.
Methods: A 13-question survey with four discrete choice experiments proposing hypothetical care scenarios was offered to patients over a 6-week period in 2018. Descriptive statistics and chi-squared tests evaluated results by sex for categorical variables, Mann-Whitney rank-sum test for continuous variables, and multivariable models adjusted for age, marital status, education, and income. P-values < 0.05 were statistically significant.
Results: A majority of 796 of 1731 (46%) respondents were female (56%) and over age 65 (58.5%). Females were more likely than males to prefer communicating with the same allied health staff (AHS) over receiving a quick response (female 36.3% vs male 28.0%, p=0.0031) Females prioritized seeing their own provider as opposed to scheduling a convenient appointment for routine care (female 90.2% vs male 85.0%, p =0.028). Multivariable analysis found that females were 6% less likely than males to request the same AHS for communication (95% CI 0.62-1.44), 29% less likely to request the same HCP for yearly physicals (95% CI 0.34 – 1.44), but 3% more likely than men to request an acute visit with the same HCP (95% CI 0.68-1.56) and 13% more likely to request the same HCP for virtual visits (95% CI 0.70-1.81).
Conclusion: Sex-based differences in access preferences were identified. Women preferred continuity of care with the same HCP and AHS over ease of scheduling or a quick response, though these preferences appear to be moderated by other factors including age and marital status. Further identification of longitudinal and socioeconomic factors influencing preferences is needed in this era of evolving practice models.
primary care, access, patient preferences
Taylor, G.; Poole, K.; Girardo, M.; and Kling, J., "Outpatient Primary Care Practitioner Access: Sex-Based Preferences" (2020). Sex and Gender Health Education Summit 2020 – Virtual Meeting. 29.