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Ethnic differences in health preferences: analysis using willingness-to-pay
Margaret M Byrne1, Kimberly J O'Malley, Maria E Suarez-Almazor
1Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. byrnem@pitt.edu
The Journal of Rheumatology
|September 1, 2004
Summary
Ethnic differences in health valuation influence healthcare disparities. Patient preferences for health improvements, particularly for elective procedures like knee replacement, vary significantly among racial and ethnic groups.
Area of Science:
- Health Services Research
- Health Economics
- Health Disparities
Background:
- Racial and ethnic disparities in healthcare utilization are well-documented.
- The specific impact of patient preferences on these disparities, especially for elective procedures, is not fully understood.
Purpose of the Study:
- To investigate whether health improvement preferences differ across racial and ethnic groups.
- To assess these preferences in the context of osteoarthritis (OA) of the knee, where utilization of total knee arthroplasty (TKA) varies by ethnicity.
Main Methods:
- A survey utilizing willingness-to-pay (WTP) methodology was administered to 193 white, African American, and Hispanic individuals.
- WTP for improvements in mild and severe OA, and for non-health items, was assessed.
- Multivariate regression analyses were employed to compare WTP across racial/ethnic groups, controlling for income.
Main Results:
- Willingness-to-pay (WTP) as a percentage of income was highest for whites, intermediate for Hispanics, and lowest for African Americans.
- After controlling for income, significant differences in log WTP were found between African Americans and whites, but not between Hispanics and whites.
- Racial and ethnic group status accounted for a substantial portion (21-30%) of the variation in log WTP.
Conclusions:
- Ethnic variations in health valuation and preferences are a contributing factor to disparities in the utilization of elective healthcare services.
- These findings highlight the importance of considering patient preferences in understanding and addressing healthcare utilization differences among diverse populations.