title: A contingent valuation study of the appropriate user price for ambulance service.
abstract: BACKGROUND
  In Japan, anyone can use an ambulance free of charge, but this policy may encourage unnecessary ambulance use.
  
  
  OBJECTIVE
  To determine the user price that would reduce unnecessary ambulance use, without discouraging medically necessary ambulance use.
  
  
  METHODS
  The study was conducted by means of a three-part self-administered questionnaire. The first part consisted of questions covering demographic variables such as respondent age, gender, family structure, and pretax annual household income. The second part was made up of contingent valuation questions on ambulance use. Respondents were presented hypothetical situations and prices and then asked whether they would call an ambulance. The last part consisted of general questions pertaining to the city ambulance system. Answers to the hypothetical questions were analyzed in relation to demographic characteristics of the respondents.
  
  
  RESULTS
  A total of 2,029 out of 3,363 recipients completed the questionnaire (response rate, 60.3%). Analysis of the responses indicated that the demand for ambulance service in serious situations is inelastic with respect to price, whereas the demand for ambulance service in nonserious situations is fairly elastic with respect to price. These data showed that a user charge of 190 dollars (20,000 yen) may be an acceptable price, i.e., the price that will reduce the number of ambulance calls by persons with nonserious conditions, but not by persons with serious conditions.
  
  
  CONCLUSIONS
  Introducing a user charge for ambulance service may improve efficiency of the service operation.
authors.affiliation: Department of Public Health, Yokohama City University School of Medicine, Yokohama, Japan. kenoh@med.yokohama-cu.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohshige
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kawakami
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Kubota
authors.forename: Osamu
authors.initials: O
authors.lastname: Tochikubo
mesh_terms: D000552:Ambulances / Q000191:economics* / Q000706:statistics & numerical data; D001294:Attitude to Health; D003362:Cost-Benefit Analysis; D005249:Fees and Charges / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012959:Socioeconomic Factors