Institutions, culture, and chronically ill patients’ willingness to pay for medical treatment: a meta-regression analysis

Telehealth Consultation for Malaysian Citizens' Willingness to Pay Assessed by the Double-Bounded Dichotomous Choice Method

Background

Re-envisioning healthcare in technology tools includes robust utilisation of telehealth, improvement in access, quality, care efficiencies and cost-effectiveness of healthcare services. In reality, the technology's potential to transform healthcare may be limited by the ability to pay for it. This study aims to estimate Malaysian citizens' willingness to pay (WTP) for telehealth consultations and determine the factors contributing to it. This is vital to inform decision-making about expansion, preferences and deployment of a pricing strategy for telehealth services.

Methods

A random sample of 220 adult Malaysians was surveyed using social network services (SNS). Three different WTP bid arrays were identified and each respondent received a randomly drawn bid price. The WTP fee for using the telehealth consultation for 30 min was measured and estimated using a Double-Bounded Dichotomous Choice (DBDC) and the Random Utility Logit Model.

Result

The median WTP was estimated to be RM58 (JPY2,198), RM78 (JPY2,956) for 132 respondents' willingness to use telehealth consultation and RM26 (JPY985) for 51 respondents who were unwilling. Further analysis found that WTP is correlated with the perception and willingness of the respondents to use it.

Conclusion

Despite most respondents being willing to pay for telehealth consultations, sociodemographic characteristics and affordability influenced the process of making decisions about WTP for telehealth consultation. This finding suggests that the private sector can play a crucial role in the deployment of telehealth. However, there may be a need to consider affordability and how to increase access and use of telehealth services.

Willingness to pay for haemodialysis among patients with chronic kidney disease in Abuja, Nigeria

BACKGROUND

Evidence of willingness to pay for kidney replacement therapy is scarce in low-middle-income countries, including Nigeria's Formal Sector Social Health Insurance Programme. The study, therefore, assessed the willingness to pay for haemodialysis among chronic kidney disease patients in Abuja, Nigeria.

METHODS

The study adopted a cross-sectional survey design. We used the contingent valuation method to estimate the maximum stated willingness to pay (WTP) for haemodialysis among end-stage kidney disease (ESKD) patients. We obtained informed written consent from respondents before data collection. The socio-demographic characteristics and willingness to pay data were summarized using descriptive statistics. We evaluated the mean differences in respondents' WTP using Mann-Whitney and Kruskal-Wallis tests. All variables that had p < 0.25 in the bivariate analysis were included in the Generalized Linear Model (gamma with link function) to determine the predictors of the WTP for one's and another's haemodialysis. The level of significance in the final model was ρ < 0.05.

RESULTS

About 88.3% and 64.8% of ESKD patients were willing to pay for personal and altruistic haemodialysis, correspondingly. The mean annual WTP for haemodialysis for one's and altruistic haemodialysis was USD25,999.06 and USD 1539.89, respectively. Private hospital patients were likelier to pay for their haemodialysis (β = 0.39, 95%CI: 0.21 to 0.57, p < 0.001). Patients attending public-private partnership hospitals were less likely to pay for altruistic haemodialysis than those attending public hospitals (β = -1.65, 95%CI: -2.51 to -0.79, p < 0.001).

CONCLUSIONS

The willingness to pay for haemodialysis for themselves and others was high. The type of facility ESKD patients attended influenced their willingness to pay for haemodialysis. The findings highlight the need for policies to enhance affordable and equitable access to haemodialysis in Nigeria through pre-payment mechanisms and altruistic financing strategies.

Willingness to pay for medical care and its determinants in private health care facilities among Gondar city residents, Northwest Ethiopia: Cross sectional study

Medical care is a type of health service that mainly consists of investigation and diagnosis, treatment, rehabilitative care, and nursing care for the purpose of maintaining the structure or function of the body. A medical care payment is a sort of payment made for the diagnosis, cure, mitigation, treatment, or prevention of disease, sickness, or damage, which includes checkups and periodic exams. In low-income nations, out-of-pocket expenditures account for 60 % of overall health spending, compared to 20 % in high-income ones. Willingness to pay is perhaps the highest money that a person is willing to provide to ensure that a particular wellbeing care action is undertaken. Previous research works focused mainly on the patients' willingness to pay but not the amount they can afford. The focus of this study is to determine the level of willingness to pay, the mean amount of willingness to pay for medical care, and its major determinants. A community-based cross-section study was carried out among Gondar city residents from February 2022 to March 2022. The study participants were recruited by systematic random sampling. Four data collectors conducted interviews using a questionnaire. For analysis, the dataset was entered into Epi Info version 7 and transferred to STATA version 14. The descriptive part was summarized using summary statistics like mean, median, and standard deviation. Determinants of willingness to pay were identified using a Tobit regression model with a significance of p-value ≤ 0.05 and confidence interval (CI ≠ 0). Finally, the analyzed data was presented using tables and figures accordingly. The study involved 414 participants, with a response rate of 95.8 %. About 53.62 % of the participants were willing to pay for medical care and the average willingness to pay was 24.17 USD per year. They were more willing to pay if they were still working (β = 19.66), currently married (β = 14.49), had a family history of medical care (β = 25.74), had good knowledge (β = 36.16), had a history of medical illness (β = 16.64), lived a long distance from the health facility (β = 1.98), and had a high wealth index (β = 29.51). The willingness to pay for medical care is below the actual cost. Designing a cost-recovery strategy with multi-tiered programs assigned to the most vulnerable individuals, such as the elderly, less educated, or seriously sick, is a strategic approach of the raising demand for service uptake and accessibility.

Determinants of willingness to pay for health services: a systematic review of contingent valuation studies

INTRODUCTION

Stated preference studies are a valuable tool to elicit respondents' willingness to pay (WTP) for goods or services, especially in situations where no market valuation exists. Contingent valuation (CV) is a widely used approach among stated-preference techniques for eliciting WTP if prices do not exist or do not reflect actual costs, for example, when services are covered by insurance. This review aimed to provide an overview of relevant factors determining WTP for health services to support variable selection.

METHODS

A comprehensive systematic literature search and review of CV studies assessing determinants of WTP for health services was conducted, including 11 electronic databases. Two of the authors made independent decisions on the eligibility of studies. We extracted all determinants used and related p values for the effect sizes (e.g. reported in regression models with WTP for a health service as outcome variable). Determinants were summarised in systematic evidence tables and structured by thematic domains.

RESULTS

We identified 2082 publications, of which 202 full texts were checked for eligibility. We included 62 publications on 61 studies in the review. Across all studies, we identified 22 WTP determinants and other factors from 5 thematic domains: sociodemographic characteristics, perceived threat, perceived benefit, perceived barriers, and other information.

CONCLUSION

Our review provides evidence on 22 relevant determinants of WTP for health services, which may be used for variable selection and as guidance for planning CV surveys. Endogeneity should be carefully considered before interpreting these determinants as causal factors and potential intervention targets.