Public preferences for primary healthcare services in Hong Kong: a discrete choice experiment

Primary healthcare has been recognised as an important intervention to enhance public health. Understanding public preferences in primary healthcare policy design is thus essential to achieving higher participation and better service quality through optimised resource allocation. While previous research has focused on macro-level systems, welfare frameworks, and policy legitimacy, there is a lack of literature examining the general public’s primary healthcare preferences from a micro perspective. Our study aims to bridge this gap and provide additional comparative perspectives on primary healthcare service design. We administered a discrete choice experiment to a representative sample of Hong Kong’s general population. Six attributes were developed based on a comprehensive and evidence-based investigation: (1) provider type, (2) payment option, (3) mix of healthcare providers, (4) percentage of Western medicine doctors in the healthcare team, (5) travel time required, and (6) digital services offered. Respondents were presented with six hypothetical scenarios and asked to choose one of two profiles related to these attributes in each scenario. A mixed multinomial logit model was adopted for analysis. We identified a strong public preference for primary healthcare centres run by non-profit organisations and for users to pay any incurred costs directly. Respondents preferred a mix of healthcare providers; however, a shorter travel time and digital services were not attractive to them. The standard deviations across random parameters were large, indicating heterogeneity in preferences. Our findings establish a strong preference for non-profit organisations as primary healthcare providers and for interdisciplinary healthcare teams. High heterogeneity in individual preferences across most of the attributes implies that users expect a high degree of personalisation in primary healthcare services.