Preferences of patients with severe mental disorders in social medical welfare policies: a discrete choice experiment from communities in China

Abstract

Purpose Patients with severe mental disorders in China face a heavy financial burden and are in dire need of government support to help with medical costs. At present, the implementation of social medical welfare policies for patients with severe mental disorders in China has been ineffective. This study aims to study the participation preferences of patients for these policies, and provide a basis for the next path of policies improvement.Methods A questionnaire using the discrete choice experiment has been designed. Conditional logit regression and mixed logit regression models have been constructed based on the choice preference data, while relative importance and scenario prediction analysis have been adopted to measure the emphasis level of policy attributes in patients' minds.Results All four policy attributes affect patients' preferences for policy participation, while the attributes in descending order of relative importance are starting payment line(29.10%), reimbursement rate(25.40%), drug catalogue(24.19%), and designated medical institutions(21.31%).Patients significantly preferred the policy option with no starting payment line (p < 0.01). There are also differences in the attributes that patients with different characteristics consider critical when making choices.Conclusion This study has measured demand-side preferences for policy participation from the patient's perspective. The important finding obtained is that patients' preferences for policies attributes are closely influenced by the actual details of the policies in which they are currently or have previously participated and by their level of awareness at the time they make their judgments. The direction of policies adjustment can be grasped accordingly.