Floyd Sarah B, Oostdyk Alicia, Cozad Melanie, Brooks John M, Siffri Paul, Burnikel Brian
Department of Public Health Sciences, Clemson University, Clemson, SC.
Center for Effectiveness Research in Orthopaedics, Columbia, SC.
J Patient Cent Res Rev. 2021 Apr 19;8(2):98-106. eCollection 2021 Spring.
The high cost of orthopaedic care has attracted criticism in the current value-based health care environment. The objective of this work was to assess the properties of a willingness to pay (WTP)-based approach to estimate the monetary value that patients place on health improvements in chronic knee conditions following orthopaedic treatment.
A sample of patients with a chronic knee condition were surveyed between January and May of 2018 at a large orthopaedic practice. Each patient provided their WTP for restoration to ideal knee health and completed the Single Assessment Numerical Evaluation (SANE) to describe their baseline knee state. Average WTP was calculated for the total sample and stratified by income, age, and baseline SANE (for which 0 is the worst and 100 is the best) levels. The patient-perceived monetary value of each unit of SANE improvement was assessed.
The study sample included 86 patients seeking orthopaedic care for a chronic knee condition. Mean baseline SANE score was 45.5 (standard deviation: 25.0). Mean WTP to obtain ideal knee function from baseline was $18,704 (standard deviation: $18,040). For the full sample, patients valued a 1-unit improvement in SANE score at $291.1 (β: 291.1; P<0.05). The amount of money patients were willing to pay to achieve ideal knee function varied with age, income, and baseline knee state.
Patients appear to highly value improvement in chronic knee conditions. Willingness-to-pay survey results appear to track expected variation in patient outcome valuation by income and baseline knee condition and could be a valuable approach to assess value-based care in orthopaedics.
在当前基于价值的医疗环境中，骨科护理的高昂成本引发了诸多批评。本研究的目的是评估基于支付意愿（WTP）的方法的属性，以估计患者对骨科治疗后慢性膝关节疾病健康改善所赋予的货币价值。
2018年1月至5月期间，在一家大型骨科诊所对患有慢性膝关节疾病的患者样本进行了调查。每位患者提供了恢复至理想膝关节健康状态的支付意愿，并完成了单项评估数值评定法（SANE）以描述其基线膝关节状态。计算了整个样本的平均支付意愿，并按收入、年龄和基线SANE水平（0为最差，100为最佳）进行分层。评估了患者对SANE每改善一个单位的货币价值感知。
研究样本包括86名因慢性膝关节疾病寻求骨科护理的患者。平均基线SANE评分为45.5（标准差：25.0）。从基线状态获得理想膝关节功能的平均支付意愿为18,704美元（标准差：18,040美元）。对于整个样本，患者认为SANE评分每提高1个单位的价值为291.1美元（β：291.1；P<0.05）。患者为实现理想膝关节功能愿意支付的金额随年龄、收入和基线膝关节状态而变化。
患者似乎高度重视慢性膝关节疾病的改善。支付意愿调查结果似乎反映了患者结局估值随收入和基线膝关节状况的预期变化，并且可能是评估骨科基于价值的护理的一种有价值的方法。
