title: Patient willingness to pay for preventive measures in primary care: a study of five GPs in a German community.
abstract: OBJECTIVE
  To explore the willingness of patients in a usual primary care setting to pay out-of-pocket fees for their own health promotion, in correlation with risk factors and net income, and compared to patients of an educational programme.
  
  
  METHODS
  A standardised health survey carried out in five general practices (GPs) of a small community with a special GP-based health education programme was combined with a questionnaire to explore the special attitudes of patients from a practice sample (n = 973) and from educational courses (n = 202): covering, in addition to cardiovascular risk factors, the sociodemographic factors, net income, and out-of-pocket fees that could be spent for own health promotion.
  
  
  RESULTS
  After attending an educational programme, the patient's willingness to spend 15-40 euros/month for their own health promotion was high but there was no correlation with the income (p < 0.56), in contradiction to the patients of the practice sample who would pay more money the more they earn (p < 0.001). High levels of cardiovascular risk were associated with low education (p < 0.001), but net income and willingness to pay for preventive measures did not significantly correlate with cardiovascular risk factors.
  
  
  CONCLUSIONS
  Participants of educational courses are willing to pay a rational out-of-pocket fee for preventive measures without correlation with their incomes, thus reducing the social gradient; future preventive measures should take into account that reasonable cost sharing is well accepted by well-informed patients.
authors.affiliation: Department of General Practice and Health Service Research, University of Heidelberg. armin.wiesemann@t-online.de
authors.forename: Armin
authors.initials: A
authors.lastname: Wiesemann
authors.forename: Uwe
authors.initials: U
authors.lastname: Mueller-Buehl
authors.forename: Reginald
authors.initials: R
authors.lastname: Scheidt
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Boehme
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Scheuermann
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000191:economics / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005194:Family Practice; D005251:Fees, Medical / Q000706:statistics & numerical data; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D005858:Germany; D006266:Health Education / Q000191:economics; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000191:economics*; D011320:Primary Health Care / Q000191:economics*; D013223:Statistics as Topic