Patients' priorities for medical care

Relatively little research has been done on the importance patients attach to various aspects of their medical care when their options are constrained. We studied priorities for care among 225 patients attending the medical clinics of a university teaching hospital. Eight attributes of medical care were considered: continuity, coordination, comprehensiveness, availability, convenience, cost, expertise, and compassion. Priorities were established by the method of paired comparisons. Continuity of care was the highest priority for these patients, while cost and convenience were lowest. Priorities varied in subgroups of patients defined by demographic, illness, and utilization characteristics. Patients with acute problems preferred coordination and expertise, while those with chronic problems ranked continuity higher. Patients younger than 30 years old valued coordination most; older patients preferred continuity and comprehensiveness. Since all aspects of medical care cannot be provided to all people, and choices are necessary, patients' priorities should be considered when planning health services.