Majumder MA. The sample consists of 252 patients from three medical college hospitals. Drug availability for “none” was significant at the 1% level. Indeed, patients waiting “very long” before meeting the doctor were willing to pay significantly more, 19.96 BDT, to improve the attribute (significant at the 1% level). Manage cookies/Do not sell my data we use in the preference centre. Assessing willingness to pay for improved sanitation. Higher educated patients were willing to pay more than lower educated patients to benefit from improvements for geographical proximity (0.71), waiting time (1.21; p < 0.10), staff attitudes (0.08) and seeing the same health professional (0.39) attributes. The contingent valuation method, an economic survey technique, was used. Kim T, Kwak S, Yoo S. Applying multi-attribute utility theory to decision making in environmental planning: a case study of the electric utility in Korea. 0000004580 00000 n On the other hand, rural patients were willing to pay less than urban patients to benefit from improvements over all other attributes: geographical proximity (−8.91), staff attitude (−3.57), doctor-patient relationship (−21.53), drug availability (−27.63) and chance of recovery (−15.84). The mean travel time to the hospital was about 65 minutes with significant variations between patients (±56 minutes). Terms and Conditions, Google Scholar. Random sample of 252 patients were interviewed to measure their willingness to pay for seven specified improvements in the quality of delivered medical care. Similar results were obtained for the waiting time attributes. Moreover, acute patients expressed a positive willing to pay for waiting time (0.27 BDT) and staff attitude (1.54 BDT). Moreover, drug availability for “none” and “some”, patients were willing to pay 56.03 and 19.84 BDT respectively; where the former was significant at the 1% level. The CV method is a survey-based, hypothetical and direct method to elicit monetary value for improvements in goods or services . These results also suggest that when the patient is less satisfied from their relationship with the doctor, as assessed by the calculated DPR-score, and RECOV-score they were willing to pay more to get ‘proper’ treatment and to spend longer time with the doctor. 0000100130 00000 n Assessing willingness to pay for health care quality improvements Md Sadik Pavel1, Sayan Chakrabarty1,2,3* and Jeff Gow4,5 Abstract Background: Contingent valuation (CV) is used to estimate the willingness to pay (WTP) of consumers for specific attributes to improve the quality of health care they received in three hospitals in Bangladesh. 0000011635 00000 n On the other hand, patients coming to the hospital for an acute or common illness were willing to pay more than those who come to the hospital due to improvements in waiting times (0.61), and staff attitude (3.52) attributes. The results from the seven Tobit regressions as outlined in Table 6 suggest the existence of a strong and highly significant association between stated WTP values and improvements in the seven different quality attributes. The ethics committee of the Medical Faculty, Shahjalal University of Science & Technology, approved the study. 0000001636 00000 n Thirty percent of patients came to the hospital from a “very far” distance. Riccardo Scarpa. 0000097779 00000 n Klose T. The contingent valuation method in health care. McDonald JF, Moffitt RA. Secondly, the marginal effects β′ and β″ were estimated where, β′ explained the marginal effects for the probability of being uncensored and β″ explained the marginal effects for the expected WTP value conditional on being uncensored: E (WTP | WTP > 0). However, the income variable was not very significant. Table 2 presents patients’ current estimation for the seven attributes used to measure the quality of services. 0000101768 00000 n Methods Random sample of 252 patients were interviewed to measure their willingness to pay for seven specified improvements in the quality of delivered medical care. Contingent valuation is the most commonly used stated preference technique to assess patients’ preferences  through eliciting their WTP. It is recommended that the Directorate General of Drug Administration in Bangladesh should randomly monitor implementation of maximum retail prices of its 117 listed generic items. Females expressed negative willing to pay for the Staff Attitude (−0.10 BDT), see the same health professional (−1.44 BDT), Doctor-Patient Relationship (−8.39 BDT) and Chance of Recovery (−17.64 BDT; significant at 5% level). 0000101677 00000 n By using this website, you agree to our The doctor patient relationship is critical for vulnerable patients as they valued this relationship to a large extent. Sayan Chakrabarty. Mataria A, Donaldson C, Luchini S, Moatti JP. The Tobit model has the advantage of being able to efficiently estimate the relationship between an explanatory variable and some (censored) dependent variable to estimate the probability of a dependent variable being at or below (above) a limit [14,15]. Cite this article. 0000012520 00000 n Given this situation a contingent valuation (CV) study was designed to assess peoples’ willingness to pay (WTP) for health care quality improvements. Patients meeting the same doctor “Rare” and “Often” at the hospital expressed a negative willing to pay −12.62 BDT (significant at the 1% level) and −2.64 BDT respectively. Negative WTP indicates that when patients received “very bad” behavior from staff they were willing to pay a higher user fee (WTP = 9.36) but when patients received better behavior from the staff she/he was willing to pay a lower user fee (negative value). In the local context, females usually have less control over household resources, which may explain their lower stated WTP values. Only one-fourth of the patients (22.6%) were always examined by the same doctor; about 6% of the patients rarely meet, and about 7% have never met the same doctor in the hospital. Contingent valuation (CV) is used to estimate the willingness to pay (WTP) of consumers for specific attributes to improve the quality of health care they received in three hospitals in Bangladesh. Corpus ID: 54783172. 0000007357 00000 n Am J Agric Econ. Google Scholar. 0000008077 00000 n The first two results were significant at a 1% level and the latter was significant at the 5% level. Among the three quality attributes patients treated in private hospitals are willing to pay more for drug availability but not for an improved doctor-patient relationship and improved chances of recovery. The lowest stated WTP values (21.39 BDT) concerned proposed improvements to staff attitudes. Finally, the probability that patients coming to the hospital for an acute or common illness were willing to pay less than those who come to the hospital due to other reasons to benefit from improvements in: geographical proximity (−5%), seeing the same health professional (−4%), doctor-patient relationship (−3%), drug availability (−3%) and chance of recovery (−2%) attributes. The results of this study will be useful for Government and private sector providers in allocating their funds in health care and setting appropriate user fees. Affiliations. 0000100984 00000 n 1996;16:288–99. Contingent valuation: controversies and evidence. The marginal effects are presented in Table 7 . The objective of this study is to analyze the socioeconomic and demographic factors that are related to the willingness to pay (WTP) for cancer prevention. This increasing reliance on private provision of health care in a nation with an annual per capita income just above $USD1000 means that many miss out on hospital care regardless of need, because of their poverty. Patients are willing to pay more if their satisfaction with three attributes of care are increased. Seeing the same health professional for “never” and “rare” was significant at the 5% level. Assessing Willingness to Pay for Health Care Quality Improvements Abstract Background Contingent valuation (CV) is used to estimate the willingness to pay (WTP) of consumers for specific attributes to improve the quality of health care they received in three hospitals in Bangladesh. 0000100471 00000 n Enumerators waited outside the doctor’s office for the randomly assigned patient to exit. Vol. Similar females, older patients has less elastic demand for doctor patient relationship and chance of recovery score but was significant for the doctor patient relationship score at 10% level. On the other hand, acute patients were willing to pay more than others to benefit from improvements over: waiting time (0.5%), and staff attitude (3%) attributes. R. Karina Gallardo . Springer Nature. This makes willingness to pay a crucial factor when finding the best price to sell a product at, for both the seller and buyer. At present there are 53 government and private medical colleges in Bangladesh , most of them situated in large tertiary hospitals in divisional cities. Author information: (1)Faculty of Liberal Arts and Professional Studies, York University, Toronto, Canada. Patients living in rural areas declared higher WTP values for lower waiting time (2.15) and able to meet the same health professional (2.09). The demand for healthcare can be better assessed by evaluating consumers’ willingness to pay. 0000004883 00000 n startxref Moreover, patients living “far” or at an “average” distance from the hospital were willing to pay, respectively, 15% and 17% greater than that of a patient living “very close” or “close” to a hospital. Therefore, WTP estimates are sensitive to the price ranges used in the estimation (Hensher, Rose and Greene 2015). Patients expressed a negative willing to pay for doctor-patient relationship (−0.90 BDT), drug availability (−0.81 BDT) and chance of recovery (−0.22 BDT). However, given widespread poverty, only 52% of ill people visit hospital annually and only 21% of ill people visited hospital more than three times in a year . Article CV questions are used to estimate the demand function or the willingness to pay distribution of consumers . User fees play a major role in health care in Bangladesh. Higher income earners were willing to pay more than lower income earners to benefit from improvements over all seven quality attributes: geographical proximity (0.00001), waiting time (0.0002), staff attitude (0.0002), see the same health professional (0.0008; p < 0.01), doctor-patient relationship (0.002; p < 0.01), drug availability (0.002; p < 0.01) and chance of recovery (0.002; p < 0.01). Accurately assessing consumer perceptions of prices is extremely important. 0000039371 00000 n Article CAS Partial tobit regression and … Those benefiting the most from reducing waiting times before meeting the doctor to a minimum, that is patients currently waiting “very long”, “long” and “average” before meeting the doctor were willing to pay the highest user fee increments to benefit from a “not long” waiting time. Drug availability for “none” was significant at the 1% level. There are two main reasons for people not attending hospital when ill: i) the high user fees for private sector health care and ii) the failure to receive appropriate health care in government hospitals due to overcrowding and lack of resources. Mark TL, Swait J. As a divisional city, people from surrounding areas also received health care in Sylhet. H��TMO�@��W�q}�fg��[J)-��.R�8�W�C���?��k�RQ�T9��:�ޛ�3f�0I��Q�3L �������n��V�o���`Y=d�I����.�v;d�D�������@2�»��&��dR��� 0000099400 00000 n Using stated preference and revealed preference modeling to evaluate prescribing decisions. Willingness to pay (WTP) is the maximum amount an individual is willing to hand over to procure a product or service. All authors have approved the final manuscript. 0000008976 00000 n Med Decis Mak. 0000004744 00000 n Free Online Library: Assessing the willingness of the public to pay to conserve urban green space: the Hangzhou City, China, case. Recently some major pharmaceuticals companies such as Beximco, Square, Incepta and Novartis have significantly increased medicine prices due to the high import price of raw materials and the appreciation of the dollar against Bangladeshi taka. This result also suggested that when the chance of recovery score decreased as assessed by the RECOVSC score patients willing to pay more to benefit from the doctor. Patients seeking care for acute problems were willing to pay more than chronic patients for those three attributes although there were no significant differences between acute and chronic patients for the rest of the attributes. 0000014433 00000 n 0000012379 00000 n The result for “long” was significant at the 1% level. Finally, patients coming to the hospital for an acute or common illness were willing to pay less than those who come to the hospital due to other reasons: geographical proximity (−7.44), and see the same health professional (−4.90), doctor-patient relationship (−11.48), drug availability (−15.71) and chance of recovery (−9.36) attributes were evidenced. Normally, underground car park construction is associated with urban development. Quality attributes and their corresponding measurement scales. Ramsey JB. In general, patients receiving health care from private hospitals were willing to pay more to improve the doctor patient relationship (30.008; p < 0.05) and chances of recovery attributes (22.70), and less for geographical proximity (−2.63), waiting time (−16.24; p < 0.05), staff attitude (−11.76; p < 0.05), see the same health professional (−15.91; p < 0.05), and drug availability (−17.35) attributes, compared to those attending governmental facilities. 0000092973 00000 n The quality of health care, as well as people’s preferences for health care, has changed in Bangladesh over the past 20 years. Tobin J. Estimation of relationships for limited dependent variables. Facing the increasing cost of health services and rising demand for health services, policy makers are interested in measuring the passive use value of health care services. This result suggests that patients living “very far” or “far” from the hospital were willing to pay more than those living “average” distances. Assessing willingness to pay for improved sanitation in rural Vietnam Hoang Van Minh , Hung Nguyen-Viet , Nguyen Hoang Thanh , and Jui-Chen Yang Department of Health Economics, Center for Health System Research, Institute for Preventive Medicine and Public Health, Hanoi Medical University, No 1 Ton That Tung, Dong Da, Hanoi, Vietnam Search for more papers by this author. In Sylhet, there is one public and three private medical training colleges and associated hospitals. The same interpretation is applicable for the doctor patient relationship (−1.05, significant at the 5% level). Assessing consumers’ preferences and willingness to pay for novel sliced packed fresh pears: A latent class approach. Scottish Agricultural College (SAC), King's Buildings, West Mains Road, Edinburgh EH9 3JG, United Kingdom (corresponding author: phone: +44 (0131) 535‐4217; fax: +44 (0131) 667 2601; e‐mail: Faical.Akaichi@sac.ac.uk). On the other hand, higher educated patients were willing to pay less to benefit from improvements in the doctor-patient relationship (−0.4%), drug availability (−0.2%) and chance of recovery (−0.1%) attributes. Willingness to pay values are calculated as the ratios of two parameters, with the price parameter in the denominator. (INTERNATIONAL PERSPECTIVES, awareness about green space conservation programs) by "Journal of Environmental Health"; Health, general Environmental issues Air pollution Control Public service advertising Soil erosion Environmental aspects For your product or service using a tobit regression analysis for limited dependent variables willingness... Interpretation is applicable for the three quality attributes viz construction, revision, editing and structure cost..., S. & Gow, J. assessing willingness to pay more if their satisfaction with three attributes health... The geographical location of the patient ’ s office for the other.. Cookies/Do not sell my data we use in the interview eliciting their.... Immediately after their consultation and patients ’ preferences [ 3 ] through eliciting their WTP ” values by... A product or service, Canada, Boxall p, Williams M, Louviere.! Regression analysis and Professional studies, York, York, UK of a mean chance of recovery attribute (
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