Lewallen S, Geneau R, Mahande M, Msangi J, Nyaupumbwe S, Kitumba R
Kilimanjaro Centre for Community Ophthalmology, PO Box 2254, Tumaini University/KCMC, Moshi, Tanzania.
Br J Ophthalmol. 2006 Jan;90(1):11-3. doi: 10.1136/bjo.2005.079715.
Knowing what rural populations are willing to pay for cataract surgery is essential if improvements in cost recovery in eye care service provision programmes are to take place. The authors sought to learn about willingness to pay for cataract surgery in two separate regions of Tanzania.
Patients desiring cataract surgery were interviewed in Kilimanjaro Region and Iringa Region of Tanzania to learn how much they and their families were willing to pay for surgery and how "wealthy" (using ownership of several household objects as a proxy for wealth) the household was.
60 cataract patients in Kilimanjaro and 49 in Iringa were interviewed. "Wealth" was significantly associated with willingness to pay in each region. The average expressed willingness to pay was 2457Tsh (SD 4534) or approximately $US2.30, which is far below the actual cost of providing the service.
There were significant differences in the expressed willingness to pay between Iringa and Kilimanjaro patients, which may reflect differences in the services provided in the regions. Willingness to pay may increase as the population gains familiarity and trust in the service. It may also be increased by ensuring that pricing is uniform and clearly advertised throughout regions and by educating health workers and counselling patients about the real costs of providing high quality surgery. Offering "free" services to all may result in lower expressed willingness to pay.
如果要改善眼科护理服务提供项目的成本回收情况,了解农村人口愿意为白内障手术支付的费用至关重要。作者试图了解坦桑尼亚两个不同地区患者对白内障手术的支付意愿。
在坦桑尼亚的乞力马扎罗地区和伊林加地区,对希望接受白内障手术的患者进行访谈,以了解他们及其家庭愿意为手术支付的费用,以及家庭的“富裕程度”(以拥有几件 household objects 作为财富的替代指标)。
在乞力马扎罗地区访谈了60名白内障患者,在伊林加地区访谈了49名。在每个地区,“财富”与支付意愿显著相关。平均表达的支付意愿为2457坦桑尼亚先令(标准差4534),约合2.30美元,远低于提供该服务的实际成本。
伊林加地区和乞力马扎罗地区患者表达的支付意愿存在显著差异,这可能反映了两个地区提供的服务存在差异。随着人们对该服务的熟悉和信任增加,支付意愿可能会提高。通过确保整个地区定价统一且明确宣传,以及对卫生工作者进行教育并向患者咨询提供高质量手术的实际成本,支付意愿也可能会提高。向所有人提供“免费”服务可能会导致表达的支付意愿降低。