The Role of Mental Health in Healthcare Choices: A Discrete Choice Experiment Examining Preferences for Primary Care

Objectives This study examines the role of mental health in consumer healthcare choices, using a discrete choice experiment to analyze choices regarding routine primary care visits in Australia. It captures mental health through 3 variables: self-reported current mental health condition and clinically validated measures of depression and anxiety symptoms, the Patient Health Questionnaire-9 capturing depression, and the Generalized Anxiety Disorder 7-item scale capturing anxiety. Methods Data were collected during November and December 2021 from a sample (N = 568) representative of the Australian population in age, gender, and location. Participants made hypothetical choices between in-person and telehealth alternatives or a no-visit alternative. Alternatives were described in terms of general practitioner familiarity, out-of-pocket cost, wait time, waiting area size, mask requirements, and modality of telehealth. Results The results suggest that symptoms of depression and anxiety could affect healthcare choices with opposite direction of effect on uptake and distinct from the presence of a mental health condition. Conclusions These findings support the need for more careful consideration of the role of mental health in the analysis of discrete choice experiments, particularly in healthcare, including a better understanding of the mechanisms and time-varying nature of any effect.