title: Factors affecting patient valuations of caries prevention: Using and validating the willingness to pay method.
abstract: OBJECTIVE
  Determining the value of, or strength of preference for health care interventions is useful for policy makers in planning health care services. Willingness to pay (WTP) is an established economic technique to determine the strength of preferences for interventions by eliciting monetary valuations from individuals in hypothetical situations. The objective of this study was to elicit WTP values for a dental preventive intervention and to analyze the factors affecting these as well as investigating the validity of the WTP method.
  
  
  METHODS
  Patients aged 40 years plus attending dental practices in the UK and Germany were recruited on a consecutive basis over one month. Participants received information about a novel root caries prevention intervention. They then completed a questionnaire including a WTP task. Where the coating was indicated, patients were offered this for a payment and acceptance was recorded. Analysis included econometric modelling and comparison of expected (based on stated WTP) versus actual behaviour.
  
  
  RESULTS
  The mean WTP for the coating was £96.41 (standard deviation 60.61). Econometric models showed that no demographic or dental history factors were significant predictors of WTP. 63% of the sample behaved as expected when using stated WTP to predict whether they would buy the coating. The remainder were split almost equally between those expected to pay but who did not and those who were expected to refuse but paid.
  
  
  CONCLUSIONS
  Values for a caries preventive intervention had a large and unpredictable variance. In comparing hypothetical versus real preferences both under- and over-valuation occurs.
  
  
  CONCLUSIONS
  Wide and unpredictable variation in valuations for prevention may mean that there are difficult policy questions around what resource should be allocated to dental prevention and how to target this resource.
authors.affiliation: Centre for Oral Health Research and School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4BW, UK; Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK. Electronic address: c.r.vernazza@ncl.ac.uk.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Vernazza
authors.affiliation: Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK; Newcastle University Business School, 5 Barrack Road, Newcastle upon Tyne NE1 4SE, UK.
authors.forename: John R
authors.initials: JR
authors.lastname: Wildman
authors.affiliation: Centre for Oral Health Research and School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4BW, UK; Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
authors.forename: Jimmy G
authors.initials: JG
authors.lastname: Steele
authors.affiliation: Centre for Oral Health Research and School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4BW, UK; Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
authors.forename: John M
authors.initials: JM
authors.lastname: Whitworth
authors.affiliation: Edinburgh Dental Institute, 4th Floor, Lauriston Building, Lauriston Place, Edinburgh EH3 9HA, UK.
authors.forename: Angus W G
authors.initials: AW
authors.lastname: Walls
authors.affiliation: CHX Technologies Inc., 4800 Dundas Street West, Suite 105, Toronto, Ontario M9A 1B1, Canada.
authors.forename: Ross
authors.initials: R
authors.lastname: Perry
authors.affiliation: Denplan Ltd., Denplan Court, Victoria Road, Winchester, Hampshire SO23 7RG, UK.
authors.forename: Roger
authors.initials: R
authors.lastname: Matthews
authors.affiliation: University Medical Center Freiburg, Dental School and Hospital, Department of Operative Dentistry and Periodontology, Hugstetter Strasse 55, 79104 Freiburg, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Hahn
authors.affiliation: Yunus Centre for Social Business & Health, Institutes for Applied Health Research and Society & Social Justice Research, Glasgow Caledonian University, 3rd Floor, Buchanan House, Cowcaddens Road, Glasgow G4 0BA, UK.
authors.forename: Cam
authors.initials: C
authors.lastname: Donaldson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003731:Dental Caries / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Caries; Preference-based measures; Prevention; Willingness to pay