尼日利亚东南部疟疾诊断和治疗用快速诊断检测的支付意愿：事后和事前评估。
Willingness to pay for rapid diagnostic tests for the diagnosis and treatment of malaria in southeast Nigeria: ex post and ex ante.
机构信息
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu-campus, Nigeria.
出版信息
Int J Equity Health. 2010 Jan 15;9:1. doi: 10.1186/1475-9276-9-1.
BACKGROUND
The introduction of rapid diagnostic tests (RDTs) has improved the diagnosis and treatment of malaria. However, any successful control of malaria will depend on socio-economic factors that influence its management in the community. Willingness to pay (WTP) is important because consumer responses to prices will influence utilization of services and revenues collected. Also the consumer's attitude can influence monetary valuation with respect to different conditions ex post and ex ante.
METHODS
WTP for RDT for Malaria was assessed by the contingent valuation method using a bidding game approach in rural and urban communities in southeast Nigeria. The ex post WTP was assessed at the health centers on 618 patients immediately following diagnosis of malaria with RDT and the ex ante WTP was assessed by household interviews on 1020 householders with a prior history of malaria.
RESULTS
For the ex ante WTP, 51% of the respondents in urban and 24.7% in rural areas were willing to pay for RDT. The mean WTP (235.49 naira) in urban is higher than WTP (182.05 Naira) in rural areas. For the ex post WTP, 89 and 90.7% of the respondents in urban and rural areas respectively were WTP. The mean WTP (372.30 naira) in urban is also higher than (296.28 naira) in rural areas. For the ex post scenario, the lower two Social Economic Status (SES) quartiles were more willing to pay and the mean WTP is higher than the higher two SES while in the ex ante scenario, the higher two SES quartiles were more WTP and with a higher WTP than the lower two SES quartile. Ex ante and ex post WTP were directly dependent on costs.
CONCLUSION
The ex post WTP is higher than the ex ante WTP and both are greater than the current cost of RDTs. Urban dwellers were more willing to pay than the rural dwellers. The mean WTP should be considered when designing suitable financial strategies for making RDTs available to communities.
背景
快速诊断检测（RDT）的引入提高了疟疾的诊断和治疗水平。然而，任何成功的疟疾控制都将取决于影响社区管理的社会经济因素。支付意愿（WTP）很重要，因为消费者对价格的反应将影响服务的利用和收入的收取。此外，消费者的态度可以影响不同条件下的货币价值，无论是事后还是事前。
方法
通过使用投标博弈方法，在尼日利亚东南部的农村和城市社区，采用条件价值评估法评估对疟疾 RDT 的支付意愿。事后支付意愿是在卫生中心对 618 名经 RDT 诊断为疟疾的患者进行评估的，而事前支付意愿是通过对 1020 名有疟疾既往史的家庭进行家访进行评估的。
结果
对于事前支付意愿，城市地区有 51%的受访者和农村地区有 24.7%的受访者愿意为 RDT 支付费用。城市地区的平均 WTP（235.49 奈拉）高于农村地区的 WTP（182.05 奈拉）。对于事后支付意愿，城市和农村地区分别有 89%和 90.7%的受访者愿意支付。城市地区的平均 WTP（372.30 奈拉）也高于农村地区的（296.28 奈拉）。对于事后情况，社会经济地位（SES）较低的两个四分位数更愿意支付，平均 WTP 高于 SES 较高的两个四分位数；而在事前情况下，SES 较高的两个四分位数更愿意支付，并且 WTP 高于 SES 较低的两个四分位数。事前和事后的 WTP 直接取决于成本。
结论
事后支付意愿高于事前支付意愿，两者均高于 RDT 的现行成本。城市居民比农村居民更愿意支付。在为社区提供 RDT 制定合适的财务策略时，应考虑平均 WTP。
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