engleski

WILLINGNESS-TO-PAY TREATMENT TIME: PATIENT VERSUS NON-PATIENT PREFERENCES AND THE IMPACT OF ADAPTATION ON MONETARY VALUATION

Objectives: We conducted a Contingent valuation study to estimate the monetary value (WTP) of a unit of treatment time in the domain of hemodialysis treatment in three distinct samples: (1) actual hemodialysis patients ; (2) pre-dialysis patients suffering chronic renal disease (CRD) stage 3 and 4 ; (3) healthy controls. Next reporting the estimates of a unit of treatment time, we analysed if patient’s adaptation to dialysis effects of the value of treatment time. Methods: The data was collected in the University hospital in Rijeka, Croatia. The data included the information regarding (1) the proportion of the actual and hypothetical patients who prefer to reduce their treatment time spent on dialysis (from 4 to 1 hour) ; (2) the proportion of the actual and hypothetical patients who are willing to pay out of pocket for the reduction ; (3) the average WTP per unit of time in the three groups. Results: Highest WTP for hour of treatment time (€3.42) was reported by healthy controls. Pre-dialysis patient estimated the value of €1.18 while dialysis patients reported the value of €0.91 per hour of treatment time. We found a significant and inversely correlated relationship between the monetary value of treatment time and the length of time spent receiving dialysis treatment in the group of dialysis patients. To test whether adaptation is in fact a consequence of a response shift, or a change in patient’s reference point, we compared the valuations of the same health state obtained from the three subject groups. Patients and non-patient provided the same VAS scores for the same hypothetical condition suggesting no response shift. Conclusions: The value of treatment time should not be ignored in economic evaluations. WTP and stated preference methods more generally should account for the patients’ adaptation to stable states. The development of systematic recommendations is warranted.

WTP, adaptation

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