title: Willingness of patients with ankylosing spondylitis to pay for inpatient treatment is influenced by the treatment environment and expectations of improvement.
abstract: OBJECTIVE
  To assess the willingness to pay (WTP) for treatment in a spa resort of patients with ankylosing spondylitis (AS) and to assess if the experience of a spa influences the WTP.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. aboo@sint.azm.nl
authors.forename: A
authors.initials: A
authors.lastname: Boonen
authors.forename: J L
authors.initials: JL
authors.lastname: Severens
authors.forename: A
authors.initials: A
authors.lastname: van Tubergen
authors.forename: R
authors.initials: R
authors.lastname: Landewé
authors.forename: G
authors.initials: G
authors.lastname: Bonsel
authors.forename: D
authors.initials: D
authors.lastname: van der Heijde
authors.forename: Sj
authors.initials: S
authors.lastname: van der Linden
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001317:Austria; D001452:Balneology / Q000191:economics*; D005260:Female; D005382:Financing, Personal; D006272:Health Facility Environment; D006297:Health Services Accessibility; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012047:Rehabilitation Centers / Q000191:economics; D013167:Spondylitis, Ankylosing / Q000191:economics* / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome