Objectives This study aimed to assess patients’ healthcare-seeking preferences in mild, chronic, and serious illness; identify influential factors; and examine the reasons underlying patients’ healthcare-seeking preference.

Design A retrospective study.

Setting The study was conducted in 14 tertiary hospitals in Shanghai, China.

Participants Questionnaires were distributed to 1519 patients, and 1114 were completed and returned. All patients participated in the study voluntarily, provided written informed consent, and possessed the ability to complete the questionnaire.

Main outcome measures We measured and compared preferences and choice of healthcare providers in patients if they had experienced mild, chronic, or serious illness.

Results More than 50% of participants, including those who were >60 years of age, had consulted a doctor more than three times during the preceding year, were single, and were most likely to decide not to seek medical treatment. Community health facilities were the most frequently selected healthcare provider in mild illness. In addition, patients who had no personal preference, did not express a preference for a good environment or first-class medical technology, were concerned about close proximity and short waiting times, and pursued low medical costs were most likely to choose a community health facility. General hospitals were the most frequently selected healthcare provider in chronic and serious illness. In addition, patients who earned higher monthly incomes, did not pursue low medical costs, were not concerned about short waiting times or close proximity, and expressed a preference for first-class medical technology, were most likely to choose general hospitals.

Conclusion Patients’ healthcare-seeking preference was influenced mainly by healthcare providers’ characteristics, illness severity, and sociodemographic characteristics. These findings indicate that patients’ current healthcare-seeking preference was not ideal and requires optimisation.