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.
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.
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.
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.
This study explores how mental health impacts the decisions people make about routine primary care visits in Australia, especially during the COVID-19 pandemic. The research used a method called a discrete choice experiment to understand how symptoms of depression and anxiety might influence these healthcare choices. This study is important because it sheds light on how mental health conditions can affect decision-making processes, which is crucial for improving healthcare delivery and policy making.
The research involved 568 participants who were representative of the Australian population in terms of age, gender, and location. They were asked to choose between different healthcare options, including in-person visits, telehealth visits, or not visiting at all. The options varied based on factors such as the familiarity with the general practitioner, cost, wait time, and whether masks were required. Researchers measured mental health using validated tools: the Patient Health Questionnaire-9 for depression and the Generalized Anxiety Disorder 7-item scale for anxiety.
Key findings indicate that symptoms of depression and anxiety can influence healthcare choices but in different ways. People with higher levels of depression were less likely to choose telehealth visits. While several explanations for this are possible, people with lived experience of depression have reported that depression could make it harder to communicate and juggle technology during such visits. On the other hand, those with higher anxiety levels were more inclined to choose telehealth options as well as in-person visits. This may indicate either that anxiety increases aversion to the risks of forgoing care or desire for reassurance.
Overall, this research suggests that mental health should be more carefully considered in analyzing healthcare preferences, even when the choices aren’t directly related to mental health. However, the findings are based on data collected during a specific time period, focused on a single decision context, and limited to one country. Further research is needed to determine whether these patterns hold across different healthcare contexts and settings.