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PURPOSE The consultation is fundamental to the delivery of primary care, but different ways of organizing consultations may lead to different patient experiences in terms of access, continuity, technical quality of care, and communication. Patients' priorities for these different issues need to be understood, but the optimal methods for assessing priorities(More)
BACKGROUND Responding to the preferences of patients is a key focus of current health policy and is especially important in primary care. Responding effectively to patient preferences requires a clear understanding of the way in which patients assess primary care services. OBJECTIVE This study was designed to provide a 'map' of the content and structure(More)
Government policy promoting consumerism in healthcare can be seen as offering up certain preferred identities to which its citizens are encouraged to aspire. Whilst many commentators reject the notion that health services users should be conceived of as consumers, this paper outlines the relevance of the concept to our understanding of the ways in which(More)
BACKGROUND Diagnostic errors are costly and they can contribute to adverse patient outcomes, including avoidable deaths. Differential diagnosis (DDX) generators are electronic tools that may facilitate the diagnostic process. METHODS AND FINDINGS We conducted a systematic review and meta-analysis to investigate the efficacy and utility of DDX generators.(More)
Individual-focused self-management interventions are one response to both an ageing society and the purported increase in chronic conditions. They tend to draw on psychological theories in self-management interventions, but over-reliance on these theories can reinforce a narrow focus on specified attitudinal and behavioural processes, omitting aspects of(More)
BACKGROUND Delivering effective health care within limited budgets requires an understanding of patient priorities. Discrete choice experiments (DCEs) provide patients with choices, where each choice differs in terms of certain attributes (such as waiting times, quality of care). Although this technique has significant potential in examining priorities, its(More)
BACKGROUND Qualitative systematic reviews are increasing in popularity in evidence based health care. Difficulties have been reported in conducting literature searches of qualitative research using the PICO search tool. An alternative search tool, entitled SPIDER, was recently developed for more effective searching of qualitative research, but remained(More)
OBJECTIVES To explore the views of NHS dentists in England regarding reforms, which changed their incentive and payment structure. METHODS Semi-structured interviews with 35 dentists, digitally recorded, transcribed verbatim and analysed using a constant comparative method. RESULTS Dentists reported changing their behaviour in response to incentives in(More)
Recent reforms, which change incentive and accountability structures in the English National Health Service, can be conceptualised as trying to shift the dominant institutional logic in the field of primary medical care (general medical practice) away from medical professionalism towards a logic of "population based medicine". This paper draws on interviews(More)
BACKGROUND Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care(More)