# Rehabilitation status and preference for medical choice behaviours of long COVID-19 in China: a national cross-sectional study and discrete choice experiment

## TL;DR

This study explores the rehabilitation status and healthcare preferences of long COVID-19 patients in China, revealing common symptoms and the importance of accessible, affordable care.

## Contribution

The study introduces a national cross-sectional and discrete choice experiment to assess long COVID-19 rehabilitation and medical preferences in China.

## Key findings

- Fatigue was the most common long COVID-19 symptom, affecting 72.67% of participants.
- Medical distance was the strongest factor influencing healthcare preferences, with closer proximity preferred.
- Integrated traditional Chinese and Western medicine services were favored by long COVID-19 patients.

## Abstract

Long COVID-19 has emerged as a growing global public health challenge requiring patient-centred responses, yet its prevalence and management are often underestimated. We aimed to investigate the rehabilitation status and medical choice behaviours among patients with long COVID-19 in China during the Omicron wave.

We conducted a national cross-sectional study and a discrete choice experiment (DCE) in China from 4 July to 11 August 2023. We used the modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm) to assess rehabilitation status. We collected preferences for medical choice behaviours of long COVID-19, demographics, health-related factors, and COVID-19 history. We assessed preferences for medical choice behaviours among people with long COVID-19 using mixed logit models.

Among 2942 participants health status was significantly poorer than before COVID-19 infection. The prevalence of common symptoms assessed by C19-YRSm ranged from 21.52% to 72.67%, with fatigue (72.67%) being the most common, followed by breathlessness on walking up a flight of stairs (64.96%) and sleep problems (62.95%). Of these symptoms, the majority of participants (15.06–47.65%) reported mild problems. Of the five functional limitations, difficulty with other activities of daily living (31.03%) was the most common, followed by difficulty with communication (28.04%), while difficulty with personal care (9.65%) was the least common. The DCE results showed that the strongest attribute affecting preferences was medical distance (β = −1.135). While seeking healthcare for long COVID-19, people preferred lower out-of-pocket costs, a closer distance, a higher hospital level, nutritional supportive therapies or rehabilitation training, and medical services that integrate traditional Chinese and Western medicine.

A substantial proportion of individuals developed long COVID-19 symptoms and functional limitations, most of which were mild. These findings highlight the importance of ongoing screening and comprehensive, tailored rehabilitation services to promote recovery and avert a public health crisis of long COVID-19.