Patient Valuation of Visit Types, Speed of Care, and Continuity With Primary Care Physicians: A Discrete-Choice...

Since the COVID-19 pandemic, there has been rapid uptake of portal messaging by patients to address acute and chronic health conditions. Demand for in-person appointments has remained high. It is not known how US patients value trade-offs between rapid portal care, a shorter wait for a visit with any available physician, or a longer wait to see their primary care physician. We used a discrete-choice experiment to elicit patient preferences for different types of care delivery and clinician type, varying time to appointment.

In 2023 our academic family medicine department queried adult patients about 6 theoretical health concerns and asked them to choose among 4 modes of care with different time frames. The modes of care were: (1) portal messaging with their primary care physician; (2) video visit with a different physician; (3) video visit with their primary care physician; or (4) in-person visit with their primary care physician. We weighted results by gender, race, and age and calculated patient preferences overall and by demographic subcategories.

We received 2,268 usable surveys out of 2,411 (50.4%) responses from 4,780 surveys sent. For all 6 health concerns, patients opted for a 3-day portal message response from their primary care physician over a longer wait for video or in-person visits with their primary care physician or with another physician.

Primary care patients expressed a robust preference for rapid-response portal messaging to address health needs. This raises important concerns about how to support patient desires for this mode care while restructuring primary care infrastructure to ensure financial support for continued safe and sustainable primary care.