Patient Healthcare Seeking If There Were No Limits

Ongoing changes in the operations and constraints of the health care system are likely affecting how patients make decisions about care seeking. Therefore, we analyzed data from a national survey asking people where they would seek care if they had no limits.

We conducted surveys of patient experiences and perceptions regarding primary care delivery and access during the pandemic, one of which conducted during November 15 to 23, 2021 included a question asking: "If you had no limits (such as insurance coverage, or what you could afford), what would be your first choice for handling most of your health concerns?" A multidisciplinary team analyzed responses using a 3-step process: identified categories using a grounded approach, tallied category frequencies using a template-based coding approach, and involved an auditor to search for confirming/disconfirming data.

Among 1,211 respondents with usable answers, the most frequent first preference for handling most health concerns was primary care (49.1%). Other common responses were hospital or health system (11.9%), a convenient/easily accessible source (11.6%), the current source of care (8.3%), a source that would provide quality care (8.2%), or a specialist (8.0%). Less common preferences include urgent care, clinicians with whom the respondent had a relationship, a specific procedure or treatment, self-care, alternative medicine, mental/behavioral health care, holistic/wellness/preventive medicine, or pharmacy.

A majority of respondents among a large national sample of patients preferred primary care for handling most health concerns. Given the known benefits of primary care, systems should support, rather than constrain, that preference.