Preferences for the delivery of early abortion services in Australia: a discrete choice experiment

Background Abortion is a common procedure in Australia; it is estimated that the rate is between 15 and 17 per 1000 women. Surgical and medical abortion options are available; however, the use of medical abortion is not as common as in other similar countries. The aim of this study is to understand preferences for the provision of early abortion services in Australia. Methods We conducted a survey of 821 members of an online panel representative of the Australian adult general population. The survey consisted of a discrete choice experiment including 16 choice tasks and a number of follow-up questions. A mixed logit model was used to analyse the responses to the discrete choice experiment. Results Respondents preferred services that provided surgical abortion compared with early medical abortion (EMA). They preferred consultations with a specialist gynaecologist compared with a general practitioner (GP); consultations with a GP were preferred to those with a nurse practitioner. Face-to-face consultations were preferred to telehealth. For EMA, respondents preferred to collect medication from the doctor's surgery rather than from a pharmacy or to receive it by post. Overall, respondents preferred lower-cost services. There were no differences in preferences between respondents with or without experience of abortion or between genders. Conclusions Respondents prefer abortion services with low out-of-pocket costs. Their reluctance to use a nurse-led service may reflect the general public's lack of understanding of and familiarity with the training and expertise of nurse practitioners. Similarly, the safety and benefits of EMA relative to surgery, including EMA delivered by telehealth, need to be emphasised.