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埃塞俄比亚西北部外展服务点白内障患者对白内障手术的支付意愿及其影响因素。

Willingness to pay for cataract surgery and associated factors among cataract patients in Outreach Site, North West Ethiopia.

机构信息

Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

出版信息

PLoS One. 2021 Mar 24;16(3):e0248618. doi: 10.1371/journal.pone.0248618. eCollection 2021.

Abstract

INTRODUCTION

In Ethiopia, cataract surgery is mainly provided by donors free of charge through outreach programs. Assessing willingness to pay for patients for cataract surgery will help explain how the service is valued by the beneficiaries and design a domestic source of finance to sustain a program. Although knowledge concerning willingness to pay for cataract surgery is substantive for developing a cost-recovery model, the existed knowledge is limited and not well-addressed. Therefore, the study aimed to assess willingness to pay for cataract surgery and associated factors among cataract patients in Outreach Site, North West Ethiopia.

METHODS

A cross-sectional outreach-based study was conducted on 827 cataract patients selected through a simple random sampling method in Tebebe Gion Specialized Hospital, North West Ethiopia, from 10/11/2018 to 14/11/2018. The data were collected using a contingent valuation elicitation approach to elicit the participants' maximum willingness to pay through face to face questionnaire interviews. The descriptive data were organized and presented using summary statistics, frequency distribution tables, and figures accordingly. Factors assumed to be associate with a willingness to pay were identified using a Tobit regression model with a p-value of <0.05 and confidence interval (CI ≠ 0).

RESULTS

The study involved 827 cataract patients, and their median age was 65years. About 55% of the participants were willing to pay for the surgery. The average amount of money willing to pay was 17.5USD (95% CI; 10.5, 35.00) and It was significantly associated with being still worker (β = 26.66, 95% CI: 13.03, 40.29), being educated (β = 29.16, 95% CI: 2.35, 55.97), free from ocular morbidity (β = 28.48, 95% CI: 1.08, 55.90), duration with the condition, (β = -1.69, 95% CI: -3.32, -0.07), admission laterality (β = 21.21, 95% CI: 3.65, 38.77) and remained visual ability (β = -0.29, 95% CI (-0.55, -0.04).

CONCLUSIONS

Participants' willingness to pay for cataract surgery in outreach Sites is much lower than the surgery's actual cost. Early intervention and developing a cost-recovery model with multi-tiered packages attributed to the neediest people as in retired, less educated, severely disabled is strategic to increase the demand for service uptake and service accessibility.

摘要

简介

在埃塞俄比亚,白内障手术主要由捐赠者通过外展项目免费提供。评估白内障患者对手术的支付意愿有助于解释服务对受益人的价值,并设计国内资金来源以维持该项目。尽管了解白内障手术的支付意愿对于制定成本回收模式很重要,但现有知识有限且未得到充分解决。因此,本研究旨在评估西北埃塞俄比亚特贝比·吉昂专科医院外展点白内障患者的支付意愿及其相关因素。

方法

这是一项基于横断面的外展研究,于 2018 年 10 月 11 日至 11 月 14 日在西北埃塞俄比亚特贝比·吉昂专科医院采用简单随机抽样方法对 827 名白内障患者进行了调查。通过面对面问卷访谈,使用条件价值评估法收集参与者的最大支付意愿数据。使用描述性数据,通过汇总统计数据、频率分布表和相应的图表进行组织和呈现。使用 Tobit 回归模型识别与支付意愿相关的因素,p 值<0.05,置信区间(CI ≠ 0)。

结果

该研究涉及 827 名白内障患者,中位年龄为 65 岁。约 55%的参与者愿意为手术付费。平均愿意支付的金额为 17.5 美元(95%置信区间:10.5,35.00),且与仍在工作(β=26.66,95%置信区间:13.03,40.29)、受教育程度(β=29.16,95%置信区间:2.35,55.97)、无眼部疾病(β=28.48,95%置信区间:1.08,55.90)、患病时间(β=-1.69,95%置信区间:-3.32,-0.07)、入院侧位(β=21.21,95%置信区间:3.65,38.77)和现有视力能力(β=-0.29,95%置信区间(-0.55,-0.04)显著相关。

结论

外展点白内障患者的支付意愿远低于手术的实际成本。早期干预和制定具有多层次套餐的成本回收模式,优先考虑退休人员、受教育程度较低者和严重残疾者,对于提高服务利用率和可及性的需求具有战略意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/431e/7990211/1b74c298ecc8/pone.0248618.g001.jpg

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