PT  - JOURNAL ARTICLE
AU  - Nathan N. O’Hara
AU  - Gerard P. Slobogean
AU  - Tima Mohammadi
AU  - Carlo A. Marra
AU  - Milena R. Vicente
AU  - Amir Khakban
AU  - Michael D. McKee
TI  - Are patients willing to pay for total shoulder arthroplasty? Evidence from a discrete choice experiment
AID  - 10.1503/cjs.011915
DP  - 2016 Apr 01
TA  - Canadian Journal of Surgery
PG  - 107--112
VI  - 59
IP  - 2
4099  - http://canjsurg.ca/content/59/2/107.short
4100  - http://canjsurg.ca/content/59/2/107.full
SO  - CAN J SURG2016 Apr 01; 59
AB  - Background: Total shoulder arthroplasty (TSA) is a common treatment to decrease pain and improve shoulder function in patients with severe osteoarthritis (OA). In Canada, patients requiring this procedure often wait a year or more. Our objective was to determine patient preferences related to accessing TSA, specifically comparing out-of-pocket payments for treatment, travel time to hospital, the surgeon’s level of experience and wait times.Methods: We administered a discrete choice experiment among patients with end-stage shoulder OA currently waiting for TSA. Respondents were presented with 14 different choice sets, each with 3 options, and they were asked to choose their preferred scenario. A conditional logit regression model was used to estimate the relative preference and willingness to pay for each attribute.Results: Sixty-two respondents completed the questionnaire. Three of the 4 attributes significantly influenced treatment preferences. Respondents had a strong preference for an experienced surgeon (mean 0.89 ± standard error [SE] 0.11), while reductions in travel time (−0.07 ± 0.04) or wait time (−0.04 ± 0.01) were of less importance. Respondents were found to be strongly averse (−1.44 ± 0.18) to surgical treatment by a less experienced surgeon and to paying out-of-pocket for their surgical treatment (−0.56 ± 0.05).Conclusion: Our results suggest that patients waiting for TSA to treat severe shoulder OA have minimal willingness to pay for a reduction in wait time or travel time for surgery, yet will pay higher amounts for treatment by an experienced surgeon.