The use of discrete choice experiments in evaluating telehealth: a systematic review

Background There is a growing body of evidence from discrete choice experiments related to telehealth. Discrete choice experiments offer valuable insights in informing the design and evaluation of telehealth services and supporting the telehealth implementation and policy. Objective This review aims to examine studies assessing consumer preferences for telehealth using discrete choice experiments. Methods A systematic review was conducted, searching five health and multidisciplinary databases from inception until 4 April 2024. Grey literature searches, hand-searching, and reference list checks were also performed. Results Of 2,832 studies screened, 52 met the inclusion criteria. Most studies were conducted from the patient perspective (n=47/52, 90%) and covered a wide range of populations and settings. Of the included studies eligible for quality assessment, 68% (n=23/34) received high-quality ratings, while others were assessed as moderate. Studies comparing face-to-face consultations with telehealth generally found a preference for face-to-face appointments. Telehealth is viewed more favourably if it can be offered at a lower cost, reduces wait times, and is part of a comprehensive care plan. Telehealth tends to be preferred by younger patients and clinicians, those digitally literate, and those with less severe or more private and stigmatised health conditions. Conclusion While face-to-face consultations are generally preferred, telehealth is viewed as advantageous if it reduces costs, shortens wait times, and is integrated into comprehensive care. The findings highlight the importance of considering these attributes when designing telehealth preference studies and informing the adoption and design of telehealth services.