Wang Lidan, Chen Zhu, Chen Sixuan, Jin Xinyu, Hu Lu, Jiang Jiacheng, Yu Hong, Xu Jianguang, Xu Wenhua
Stomatologic Hospital & College, Key Lab of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, Anhui, China
School of Health Management, Anhui Medical University, Hefei, China.
BMJ Open. 2024 Dec 23;14(12):e084776. doi: 10.1136/bmjopen-2024-084776.
The objective of this study is to analyse the preferences of guardians of school-aged children for children's caries prevention services (CPS) and their willingness to pay (WTP) for different levels of attributes.
Four key attributes were identified through a literature review and expert consultations: preventive service time, preventive effectiveness, distance (driving time to service institution) and service cost (out-of-pocket for CPS). A D-efficient design was used to create a discrete choice experiment questionnaire, and data were collected via face-to-face interviews.
Data collection was conducted between July 2021 and January 2022 in Anhui, China.
Guardians (785) of children aged 3-12 years participated.
A mixed-logit model was used to estimate preferences and WTP for different attribute levels, and the preference heterogeneity was assessed using a latent class logit model.
Preventive effectiveness was the most important attribute, followed by service cost, preventive service time and distance. Guardians preferred CPS with over 90% preventive effectiveness, a distance of 10-25 min, services offered during vacations and lower service cost. Guardians were willing to pay 409 Chinese yuan (CNY) for higher effectiveness, 84 CNY for shorter distances and 87 CNY for services offered during vacation. Guardians with a college education or higher and females prioritise preventive effectiveness, while guardians who had children with a caries history and who had children with better oral health status preferred CPS during vacation.
All four attributes influenced guardians' preferences for CPS, with preventive effectiveness being the most important. Guardians were willing to pay extra money for better CPS, and preferences varied according to individual characteristics. These findings provide a reference for policy-makers to provide personalised, demand-based CPS.
本研究旨在分析学龄儿童监护人对儿童龋齿预防服务（CPS）的偏好以及他们对不同属性水平的支付意愿（WTP）。
通过文献综述和专家咨询确定了四个关键属性：预防服务时间、预防效果、距离（驾车前往服务机构的时间）和服务成本（CPS的自付费用）。采用D效率设计创建离散选择实验问卷，并通过面对面访谈收集数据。
2021年7月至2022年1月在中国安徽进行数据收集。
785名3至12岁儿童的监护人参与了研究。
使用混合逻辑模型估计对不同属性水平的偏好和支付意愿，并使用潜在类别逻辑模型评估偏好异质性。
预防效果是最重要的属性，其次是服务成本、预防服务时间和距离。监护人更喜欢预防效果超过90%、距离为10 - 25分钟、在假期提供服务且服务成本较低的CPS。监护人愿意为更高的效果支付409元人民币（CNY），为更近的距离支付84元CNY，为假期提供的服务支付87元CNY。受过大学及以上教育的监护人和女性优先考虑预防效果，而孩子有龋齿病史的监护人和孩子口腔健康状况较好的监护人更喜欢在假期提供的CPS。
所有四个属性都影响监护人对CPS的偏好，其中预防效果最为重要。监护人愿意为更好的CPS支付额外费用，且偏好因个人特征而异。这些发现为政策制定者提供基于需求的个性化CPS提供了参考。
