PD17-10 ASSIGNING VALUE TO THE PERSONAL PATIENT PROFILE-PROSTATE DECISION AID: A WILLINGNESS TO PAY ANALYSIS

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making II1 Apr 2016PD17-10 ASSIGNING VALUE TO THE PERSONAL PATIENT PROFILE-PROSTATE DECISION AID: A WILLINGNESS TO PAY ANALYSIS Donna Berry, Traci Blonquist, Leslie Wilson, Barbara Halpenny, and Fangxin Hong Donna BerryDonna Berry More articles by this author , Traci BlonquistTraci Blonquist More articles by this author , Leslie WilsonLeslie Wilson More articles by this author , Barbara HalpennyBarbara Halpenny More articles by this author , and Fangxin HongFangxin Hong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1175AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Use of a decision aid may be a reasonable step within the clinical decision making process, perhaps as valuable to patients as a preliminary consultation session with a clinician (Medicare rate for 20 minute visit=$75). The benefit of decision making aids can be valued in monetary terms using the willingness to pay (WTP) approach. The objective of this analysis was to estimate patients' WTP for the Personal Patient Profile-Prostate (P3P), a Web-based decision support system that has been shown to decrease decisional conflict in men newly diagnosed with localized prostate cancer. METHODS A bidding questionnaire format, delivered by telephone one week after the P3P-prepared options consultation, was employed to elicit WTP in a sample of men from geographically diverse research sites. Participants were randomly assigned to a high or low WTP starting value (SV), which triggered assessment higher or lower WTP amounts until their maximum value was reached. Linear models were used to explore the univariate association between SV-adjusted WTP and baseline characteristics including age, education, marital and work status, income, insurance, decision control preference level and decision-making stage. Backwards elimination and stepwise selection methods with 0.25 entry significance and 0.1 to remain in the model were used in multivariable model building. Possible two-way interactions were checked and type III p-values were used to assess overall significance in all models. RESULTS 134 participants were offered the P3P; 117 provided a WTP dollar amount. The overall WTP was $80.22 (95% CI $57.25-$103.18); $61.67 (95% CI $30.64-$92.70) and $101.85 (95% CI $68.34-$135.37) for low and high SV, respectively. Adjusting for SV, participants who are not married/partnered (p=0.003) and/or with low income (p=0.001) reported significantly higher WTP. The final multivariable model consisted of SV, age, and income. All three two-way interactions were marginally significant: SV*age (p=0.07), income*age (p=0.08) and SV*income (p=0.06) CONCLUSIONS Participants were able to use the WTP method and valued the P3P decision aid slightly more than the value of a 20 minute office consult. P3P may be an important preliminary step to prepare men with localized prostate cancer for consult visits and decision making. The finding that lower household income was associated with higher WTP suggests unexpected and complex relationships between income and health care spending. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e402 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Donna Berry More articles by this author Traci Blonquist More articles by this author Leslie Wilson More articles by this author Barbara Halpenny More articles by this author Fangxin Hong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...