Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, United Kingdom.
Digital Health and Wellness Group, Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom.
JMIR Mhealth Uhealth. 2019 Jan 17;7(1):e3. doi: 10.2196/mhealth.9990.
Changing population demographics and technology developments have resulted in growing interest in the potential of consumer-facing digital health. In the United Kingdom, a £37 million (US $49 million) national digital health program delivering assisted living lifestyles at scale (dallas) aimed to deploy such technologies at scale. However, little is known about how consumers value such digital health opportunities.
This study explored consumers' perspectives on the potential value of digital health technologies, particularly mobile health (mHealth), to promote well-being by examining their willingness-to-pay (WTP) for such health solutions.
A contingent valuation study involving a UK-wide survey that asked participants to report open-ended absolute and marginal WTP or willingness-to-accept for the gain or loss of a hypothetical mHealth app, Healthy Connections.
A UK-representative cohort (n=1697) and a dallas-like (representative of dallas intervention communities) cohort (n=305) were surveyed. Positive absolute and marginal WTP valuations of the app were identified across both cohorts (absolute WTP: UK-representative cohort £196 or US $258 and dallas-like cohort £162 or US $214; marginal WTP: UK-representative cohort £160 or US $211 and dallas-like cohort £151 or US $199). Among both cohorts, there was a high prevalence of zeros for both the absolute WTP (UK-representative cohort: 467/1697, 27.52% and dallas-like cohort: 95/305, 31.15%) and marginal WTP (UK-representative cohort: 487/1697, 28.70% and dallas-like cohort: 99/305, 32.5%). In both cohorts, better general health, previous amount spent on health apps (UK-representative cohort 0.64, 95% CI 0.27 to 1.01; dallas-like cohort: 1.27, 95% CI 0.32 to 2.23), and age had a significant (P>.00) association with WTP (UK-representative cohort: -0.1, 95% CI -0.02 to -0.01; dallas-like cohort: -0.02, 95% CI -0.03 to -0.01), with younger participants willing to pay more for the app. In the UK-representative cohort, as expected, higher WTP was positively associated with income up to £30,000 or US $39,642 (0.21, 95% CI 0.14 to 0.4) and increased spending on existing phone and internet services (0.52, 95% CI 0.30 to 0.74). The amount spent on existing health apps was shown to be a positive indicator of WTP across cohorts, although the effect was marginal (UK-representative cohort 0.01, 95% CI 0.01 to 0.01; dallas-like cohort 0.01, 95% CI 0.01 to 0.02).
This study demonstrates that consumers value mHealth solutions that promote well-being, social connectivity, and health care control, but it is not universally embraced. For mHealth to achieve its potential, apps need to be tailored to user accessibility and health needs, and more understanding of what hinders frequent users of digital technologies and those with long-term conditions is required. This novel application of WTP in a digital health context demonstrates an economic argument for investing in upskilling the population to promote access and expedite uptake and utilization of such digital health and well-being apps.
人口结构的变化和技术的发展使得消费者关注的数字健康的潜力越来越大。在英国，一项耗资 3700 万英镑（4900 万美元）的国家数字健康计划旨在大规模推广辅助生活方式（达拉斯计划），旨在大规模部署此类技术。然而，对于消费者如何看待这些数字健康机会的价值，人们知之甚少。
本研究通过考察消费者对移动健康（mHealth）等数字健康技术促进健康的潜在价值的看法，特别是通过检查他们对这些健康解决方案的支付意愿（WTP），来探讨消费者的观点。
一项涉及英国范围的调查的条件价值研究，要求参与者报告对假设的 mHealth 应用程序 Healthy Connections 的潜在和边际 WTP 或接受意愿的开放式绝对和边际 WTP。
调查了一个具有英国代表性的队列（n=1697）和一个类似于达拉斯（代表达拉斯干预社区）的队列（n=305）。在两个队列中都发现了对该应用程序的积极的绝对和边际 WTP 估值（绝对 WTP：英国代表性队列 £196 或 US $258 和类似于达拉斯的队列 £162 或 US $214；边际 WTP：英国代表性队列 £160 或 US $211 和类似于达拉斯的队列 £151 或 US $199）。在两个队列中，绝对 WTP（英国代表性队列：467/1697，27.52%和类似于达拉斯的队列：95/305，31.15%）和边际 WTP（英国代表性队列：487/1697，28.70%和类似于达拉斯的队列：99/305，32.5%）的零值都很高。在两个队列中，更好的一般健康状况、以前在健康应用程序上的花费（英国代表性队列 0.64，95%CI 0.27 至 1.01；类似于达拉斯的队列：1.27，95%CI 0.32 至 2.23）和年龄与 WTP 有显著（P>.00）关联（英国代表性队列：-0.1，95%CI -0.02 至 -0.01；类似于达拉斯的队列：-0.02，95%CI -0.03 至 -0.01），年轻参与者愿意为该应用程序支付更多费用。在英国代表性队列中，如预期的那样，更高的 WTP 与收入高达 30000 英镑或 39642 美元（0.21，95%CI 0.14 至 0.4）和增加现有的电话和互联网服务支出（0.52，95%CI 0.30 至 0.74）呈正相关。研究表明，在两个队列中，现有的健康应用程序的支出是 WTP 的一个积极指标，尽管效果是边际的（英国代表性队列 0.01，95%CI 0.01 至 0.01；类似于达拉斯的队列 0.01，95%CI 0.01 至 0.02）。
本研究表明，消费者重视促进健康、社交联系和医疗保健控制的 mHealth 解决方案，但并非普遍接受。为了使 mHealth 发挥其潜力，应用程序需要根据用户的可及性和健康需求进行定制，并且需要更多地了解哪些因素阻碍了数字技术的频繁使用者和长期疾病患者。在数字健康背景下，对 WTP 的这种新颖应用证明了为提高人口技能水平进行投资的经济论据，以促进此类数字健康和福祉应用的获取和加速采用和利用。
