Tang Chao-Hsiun, Liu Jin-Tan, Chang Ching-Wen, Chang Wen-Ying
School of Health Care Administration, Taipei Medical University, 250 Wu-Xing Street, Taipei 110, Taiwan.
Health Policy. 2007 Jul;82(2):251-62. doi: 10.1016/j.healthpol.2006.09.007. Epub 2006 Nov 3.
In this study, we attempted to describe and justify the use of a contingent valuation (CV) method to elicit the willingness to pay (WTP) for a drug abuse treatment program by the general public in Taiwan.
In total, 1817 CV survey questionnaires were conducted through telephone interviews from randomly dialed numbers. Subjects were members of the general public aged between 20 and 65 years, with full-time jobs, and residing in the three major Taiwanese cities of Taipei, Taichung, and Kaohsiung. Respondents' WTP for drug treatment programs was elicited for two different financing mechanisms: payment through 'compulsory' payroll tax/health insurance premiums, and through 'voluntary' donations. The WTP was modeled as a function of scenarios and policies of the treatment program, respondents' socio-demographic information, and their responses to knowledge and attitudes questions.
The general public in Taiwan was estimated to be willing to pay between NT$81.00 and NT$95.00 per month for a drug abuse treatment program, while the benefits of drug abuse treatment were estimated to range between NT$12.8 billion and NT$15.0 billion in 2004 (US$1=NT$31.9 in 2004), which was equal to around 0.15% of Taiwan's GDP for that year. The general public in Taiwan was more willing to pay for drug abuse treatment via increases in NHI premiums than via donations. Preferences for the drug abuse treatment program were also found to be sensitive to the target treated population as well as the sequence in which the WTP questions were asked.
Results of this study provide policymakers with important evidence on the monetary value of a substance abuse treatment program, allocation of healthcare resources, and a possible financing mechanism of the treatment program, which may be justified by knowledge of the WTP of the general public. This study has also advanced the knowledge of the methodological issues with regard to CV questionnaire design, and it provides a base case for further studies on drug abuse in Taiwan.
在本研究中，我们试图描述并论证使用条件价值评估（CV）方法来获取台湾普通民众对药物滥用治疗项目的支付意愿（WTP）。
通过随机拨打电话进行电话访谈，共发放了1817份CV调查问卷。调查对象为年龄在20至65岁之间、有全职工作且居住在台湾三大城市台北、台中及高雄的普通民众。针对两种不同的筹资机制，即通过“强制”工资税/医疗保险费支付以及通过“自愿”捐赠，来获取受访者对药物治疗项目的支付意愿。将支付意愿建模为治疗项目的情景和政策、受访者的社会人口学信息以及他们对知识和态度问题的回答的函数。
据估计，台湾普通民众每月愿意为药物滥用治疗项目支付新台币81.00元至95.00元，而2004年药物滥用治疗的效益估计在新台币128亿元至150亿元之间（2004年1美元 = 新台币31.9元），约占当年台湾GDP的0.15%。台湾普通民众更愿意通过增加国民健康保险（NHI）保费而非捐赠来支付药物滥用治疗费用。还发现对药物滥用治疗项目的偏好对目标治疗人群以及支付意愿问题的提问顺序敏感。
本研究结果为政策制定者提供了关于药物滥用治疗项目货币价值、医疗资源分配以及治疗项目可能的筹资机制的重要证据，这些可通过了解普通民众的支付意愿来证明其合理性。本研究还增进了对CV问卷设计方法问题的认识，并为台湾进一步开展药物滥用研究提供了一个基础案例。
