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Willingness To Pay: A Method For Measuring Preferences For Maternity Care?

Authors

  • Cam Donaldson PhD,

    1. Cam Donaldson is Professor of Health Economics at the Health Economics Research Unit, University Medical Buildings, Foresterhill, Aberdeen,
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  • Vanora Hundley MSc,

    1. Vanora Hundley is a Research Fellow in the Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Aberdeen,
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  • Tracy Mapp MSc

    1. Tracy Mapp is a Research Assistant in the Department of Public Health, University Medical Buildings, Foresterhill, Aberdeen, United Kingdom.
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Professor Cam Donaldson, Health Economics Research Unit, University Medical Buildings, Foresterhill, Aberdeen AB25 2ZD, United Kingdom.

Abstract

Background:

The aim of this study was to assess the feasibility of the use of “willingness to pay” as a measure of the benefits of intrapartum care.

Methods:

A questionnaire was mailed to 150 pregnant women booking at Aberdeen Maternity Hospital in the northeast of Scotland, giving information on options for intrapartum care compiled from a recent randomized trial of care in a midwife-managed delivery unit versus care in a consultant-led labor word. Women were asked which type of care they preferred and what would be their maximum willingness to pay for their preferred option. Data were also collected on demographic and clinical characteristics.

Results:

Most women (55%) expressed a preference for care in a midwives unit. However, strength of preference, as reflected in willingness to pay, was greater among those in the smaller group, who expressed a preference for care in a consultant-led labor ward. The willingness-to-pay results were not associated with ability to pay.

Conclusions:

These data should be used together with cost data to decide on provision of care. Given the strength of preference of the minority group, and if the cost implications are not too great, a flexible service that takes account of women's wishes should be provided, even if this goes against the trend for care of those at low risk. By analyzing choice of care by income groups and social class groupings, it is possible to examine whether willingness-to-pay results are associated with indicators of ability to pay. In this case, they were not. Willingness to pay has an advantage in allowing respondents to account for more than just health gain when valuing different types of care. (BIRTH 25:1, March 1998)

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