Understanding consumer preferences for care of adolescents with pelvic inflammatory disease.

Abstract

Objective: The objective of this study is to estimate consumers' maximum willingness-to-pay (WTP) for follow-up PID services by physicians and community health nurses (CHNs), differences by consumer type (adolescents versus parents), and the differences in health-provider predicted WTP consumer estimates and actual consumer WTP estimates.

Methods: In this IRB-approved study, a contingent valuation method was used to collect WTP data regarding co-payments to physicians or nurses for clinical service delivery from the consumers of adolescent PID services (parents and adolescents) and health providers using a national convenience sample. Consumers were recruited from an academic pediatric and adolescent medicine clinic and five health department school-based health clinics in a large urban community with high (sexually transmitted infection) STI prevalence. Participants completed a web-based survey. Data were analyzed using linear regression analyses.

Results: Adolescents were willing to pay $36 more (95 % Cl : $27.9-44.3) for community health nursing care and parents were willing to pay $48 more dollars (95 % Cl : $40.3-$57.4) than physician's predicted. There were no significant differences in adolescent and parents WTP for physician or nursing services Consumers (adolescents & parents) WTP for physician PID services were on average $18.50 higher than CHN PID services (p = 0.01). Using physician estimates for WTP as the reference group, adolescents were willing to pay $56 more (95 % Cl : $48.6-$63.4) for physician care and parents were willing to pay $66 more (95 % Cl : $59.0-$72.8) than physician's predicted.

Conclusion: Adolescents and parents are willing to pay more for physician follow-up for PID, but they are open to CHN follow-up visits based on the mean WTP for CHN visits. Since WTP also reflects the value that individuals place on a service, our data demonstrate that providers consistently underestimate the value consumers place on clinical services for x adolescents with PID.