ORIGINAL RESEARCH
Serena Lee, BA; Martha M. Gonzalez, BA; Rebecca S. Etz, PhD; Kurt C. Stange, MD, PhD
Corresponding Author: Serena Lee, BA; School of Medicine, Case Western Reserve University
Email: sxl2010@case.edu
DOI: 10.3122/jabfm.2024.24-0401R1
Keywords: Community-Based Participatory Research, Delivery of Health Care, Health Behavior, Health Care Surveys, Health Services, Health Services Research, Pandemics, Patient Satisfaction, Primary Health Care, Quality of Care, Surveys and Questionnaires
Dates: Submitted: 11-03-2024; Revised: 03-24-2025; Accepted: 04-07-2025
Status: In production.
PURPOSE: Ongoing changes in the operations and constraints of the healthcare 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.
METHODS: We conducted surveys of patient experiences and perceptions regarding primary care delivery and access during the pandemic, one of which conducted during November 15-23, 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.
MAIN FINDINGS: Among 1211 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.
CONCLUSION: 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.