Willingness of patients with ankylosing spondylitis to pay for inpatient treatment is influenced by the treatment environment and expectations of improvement

Abstract

Methods: 120 patients participating in a randomised trial comparing 3 weeks' treatment in a spa resort in Austria or in the Netherlands with a control group completed a WTP questionnaire before and after spa treatment. Patients indicated on a payment card the maximal co-payment they wanted to contribute for three scenarios that included (a) two levels of improvement in pain and stiffness and (b) two treatment environments: a rehabilitation hospital and a spa resort.

Results: At baseline, patients wanted to contribute more for the same improvement after treatment in a spa resort compared with a rehabilitation hospital (p<0.003), and were prepared to pay more when expected effects were higher (p<0.001). No differences were found between men and women, pain, or income. After the trial none of the treatment groups showed a change in their WTP.

Conclusion: The WTP of patients with AS for inpatient treatment is influenced by the treatment environment and the expected improvement. Experiencing treatment in a spa resort does not influence the co-payment.

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Figure 1.

 (A) Difference in WTP for improvement through a stay in a rehabilitation hospital as opposed to a spa resort (y axis) plotted against the cumulative proportion of patients reporting that difference in WTP (x axis). (B) Difference in WTP for a spa treatment for two levels of improvement in pain compared with one level (on a scale from 0 to 4) (y axis) plotted against the cumulative proportion of patients reporting that difference in WTP(x axis).