Ethnic differences in health preferences: Analysis using willingness-to-pay

Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
The Journal of Rheumatology (Impact Factor: 3.19). 10/2004; 31(9):1811-8.
Source: PubMed


Racial and ethnic differences in health services utilization are well recognized, but the explicit contribution of access to care, physician bias, and patient preferences to these disparities remains unclear. We investigated whether preferences for improvements in health vary among ethnic groups. We chose to assess preferences for osteoarthritis (OA) of the knee because significant differences have been observed in the utilization of total knee arthroplasty among ethnic groups, and because it is an elective procedure, where individual preferences have a major role in decision-making.
A survey using willingness-to-pay (WTP) methodology was conducted to elicit preferences for improvement in severe and mild OA and for 5 non-health items; data were collected from 193 white, African American, and Hispanic individuals over the age of 20 years. Multivariate regression analyses were used to determine whether WTP varied across racial/ethnic groups.
WTP as a percentage of income for each of the 3 scenarios was highest for whites, intermediate for Hispanics, and lowest for African Americans (e.g., 32.9%, 26.4%, and 16.7% for mild OA). Controlling for income, differences in log WTP between African Americans and whites were significant in multivariate regression analyses, whereas values for Hispanics and whites did not differ significantly. Race/ethnic group variables explained a relatively large (21-30%) part of the variation in log WTP.
The findings suggest that ethnic differences in health valuation and preferences contribute to the observed disparities in health services utilization of elective procedures such as total knee arthroplasty.

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    • "Assessing a patient's willingness to pay (WTP) is one of the most accepted methods to evaluate the acceptability of new treatment modality for the clinician. It has been used to successfully measure patient's perception in not only in dentistry,[9–11] but in fields such as orthopedics,[12] cardiology[1213] and health care service preferences.[14] Bidding is the oldest and most accepted tool to assess WTP of a patient and provides both clinicians and third party payment providers with a realistic estimate of how much a patient can spend on a new treatment modality.[15] "
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    ABSTRACT: One of the factors that dissuade patients needing tooth replacement from choosing dental implants is the prohibitive cost. Willingness to pay (WTP) is a useful tool to determine the ideal cost of an expensive procedure. The aim of this study was to study the factors that influence the willingness to pay (WTP) among patients attending a private clinic and compare them to those attending a government setup. A total of 100 patients (38 male, 62 female) who had one or more missing teeth were presented with different cost-benefit scenarios and then asked if they were willing to pay the median cost of a single implant in Riyadh city. The mean WTP price was compared using the one way-ANOVA, factors which could possibly influence patients' WTP were grouped together in a Binomial logistic regression model. Of the 100 individuals surveyed 67% said they would be willing to pay the median price for the placement of an implant. A comparison of socio-demographic factors showed that significant differences were found between gender, income groups and setting of the clinic in the mean WTP price of the patients (P < 0.05). We also found that there was a significant difference in the mean WTP price between groups with regard to the area of the missing tooth, the patients' perception of their oral health and the their desire to want an implant (P < 0.05). The majority of the patients surveyed were willing to pay the median price for an implant. Willingness to pay (WTP) is a multifactorial variable which is significantly influenced by the income of the patient, the setting of the clinic and the gender; the most significant factor being the acceptability of the implant to the patient.
    Dental research journal 11/2012; 9(6):719-24.
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    • "There is evidence that patients' preferences for surgery vary in association with gender [10,23-25], ethnicity [26-30], and age [8,13,23,31,32]. The decision-making process is also influenced by how patients calculate the trade off between perceived costs and benefits [33]; their views about likely outcomes of surgery [28,34]; and their willingness to undergo surgery [32,35,36]. "
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