Valuing the delivery of dental care: Heterogeneity in patients' preferences and willingness-to-pay for dental care attributes

Abstract

Objectives: To examine the amount of heterogeneity in patients' preferences for dental care, what factors affect their preferences, and how much they would be willing to pay for improvement in specific dental care attributes.

Methods: A discrete choice experiment (DCE) was used to elicit patients' preferences. Three alternative dental care services that differed in the type of care provider, treatment explanation, dental staff behavior, waiting time and treatment cost were described to patients. Patients (n=265) were asked to choose their preferred alternative. The study was conducted at a public dental clinic of the School of Dental Medicine, University of Zagreb. Mixed logit and latent class models were used for analysis.

Results: On average, the patients would be willing to pay €45 for getting a detailed explanation of treatment over no explanation. This was the most valued attribute of dental care, followed by dental staff behavior with marginal willingness-to-pay (WTP) of €28. Dental care provided by the faculty members and private dental care were valued similarly, while student-provided care was valued €23 less. Patients also disliked longer waiting time in the office, but this was the least important attribute. Four classes of patients with distinct preferences for dental care were identified. Older and/or more educated patients tended to give relatively less importance to treatment explanation. Higher education was also associated with a higher propensity to substitute faculty dental care with the private care providers.

Conclusions: Large heterogeneity in patients' preferences was detected. Understanding their preferences may improve the delivery of dental care.

Clinical significance: Dental care providers should pay particular attention to providing a detailed treatment explanation to their patients. Dental care for older and/or more educated patients should be more attentive to interpersonal characteristics. Faculty dental care provided by faculty members could be price competitive to private care, and student-provided care more affordable.

Keywords: Dental care; Dental practice management; Discrete choice experiment; Preference heterogeneity; Willingness-to-pay.