Associations between diagnostic activity and measures of patient experience in primary care

Lower use of endoscopies and urgent referrals for suspected cancer have been linked to poorer outcomes for patients with cancer. This study aimed to investigate the associations between general practice measures of patient experience and practice use of endoscopies or urgent referrals for suspected cancer. Using a large national patient survey, English general practices are rated for aspects of patient experience, such as ability to book an appointment (ease of access), ability to see a preferred doctor (relational continuity), and the quality of practitioner communication skills. General practices that were rated highly for the ability to see a preferred doctor, tended to use endoscopies and urgent referrals less often. In contract, practices rated higher for doctor communication used endoscopies and urgent referrals more often, and had lower proportions of patients with cancer diagnosed as emergencies. These findings indicate that both care continuity (measured as ability to see a preferred doctor) and doctor communication skills are associated with clinician decision making about diagnostic evaluation.

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