Trent Maria, Lehmann Harold, Butz Arlene, Thompson Carol, Qian Qiang, Frick Kevin D
Johns Hopkins School of Medicine, 200 N. Wolfe Street, #2064, Baltimore, Maryland 20794, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA <
Med Ther Med Reprod Gynecol Endocrinol. 2013 Oct-Dec;15(4):358-362.
The objective of this study is to estimate consumers' maximum willingness-to-pay (WTP) for follow-up PID services by physicians and community health nurses (CHNs), differences by consumer type (adolescents versus parents), and the differences in health-provider predicted WTP consumer estimates and actual consumer WTP estimates.
In this IRB-approved study, a contingent valuation method was used to collect WTP data regarding co-payments to physicians or nurses for clinical service delivery from the consumers of adolescent PID services (parents and adolescents) and health providers using a national convenience sample. Consumers were recruited from an academic pediatric and adolescent medicine clinic and five health department school-based health clinics in a large urban community with high (sexually transmitted infection) STI prevalence. Participants completed a web-based survey. Data were analyzed using linear regression analyses.
Adolescents were willing to pay $36 more (95 % Cl : $27.9-44.3) for community health nursing care and parents were willing to pay $48 more dollars (95 % Cl : $40.3-$57.4) than physician's predicted. There were no significant differences in adolescent and parents WTP for physician or nursing services Consumers (adolescents & parents) WTP for physician PID services were on average $18.50 higher than CHN PID services (p = 0.01). Using physician estimates for WTP as the reference group, adolescents were willing to pay $56 more (95 % Cl : $48.6-$63.4) for physician care and parents were willing to pay $66 more (95 % Cl : $59.0-$72.8) than physician's predicted.
Adolescents and parents are willing to pay more for physician follow-up for PID, but they are open to CHN follow-up visits based on the mean WTP for CHN visits. Since WTP also reflects the value that individuals place on a service, our data demonstrate that providers consistently underestimate the value consumers place on clinical services for x adolescents with PID.
本研究的目的是估计消费者对医生和社区健康护士（CHN）提供的盆腔炎（PID）后续服务的最大支付意愿（WTP），按消费者类型（青少年与父母）的差异，以及医疗服务提供者预测的WTP消费者估计值与实际消费者WTP估计值之间的差异。
在这项经机构审查委员会（IRB）批准的研究中，采用条件估值法，使用全国便利样本，从青少年PID服务的消费者（父母和青少年）及医疗服务提供者那里收集关于为临床服务向医生或护士支付共付费用的WTP数据。消费者是从一所学术性儿科和青少年医学诊所及一个大城市社区中五所卫生部门的校内健康诊所招募的，该社区性传播感染（STI）患病率较高。参与者完成了一项基于网络的调查。数据采用线性回归分析进行分析。
青少年愿意为社区健康护理多支付36美元（95%可信区间：27.9 - 44.3美元），父母愿意比医生预测的多支付48美元（95%可信区间：40.3 - 57.4美元）。青少年和父母对医生或护理服务的WTP没有显著差异。消费者（青少年和父母）对医生PID服务的WTP平均比对CHN PID服务高18.50美元（p = 0.01）。以医生对WTP的估计作为参照组，青少年愿意为医生护理多支付56美元（95%可信区间：48.6 - 63.4美元），父母愿意比医生预测的多支付66美元（95%可信区间：59.0 - 72.8美元）。
青少年和父母愿意为PID的医生随访支付更多费用，但基于对CHN随访的平均WTP，他们也接受CHN随访。由于WTP也反映了个人对一项服务的重视程度，我们的数据表明，医疗服务提供者一直低估了消费者对患有PID的青少年临床服务的重视程度。
