Christopher Vernazza1, Lauren Anderson2, Andrew Ian Hunter3, Helen Christine Leck4, Stephen Daniel O'Connor5, Gillian Rose Smith6, Richard Joseph Stokes7, Sarah Rolland8. 1. NIHR Clinician Scientist, Centre for Oral Health Research, Newcastle University, Framlington Place, Newcastle upon Tyne, UK. NE2 4BW, +44 (0)191 2088396. 2. Specialist Orthodontist, Milngavie Orthodontics, 13 Main Street, Milngavie, Scotland, G62 6BJ. 3. Specialist Orthodontist, Dentalign Orthodontics, 55 Burscough Street, Ormskirk, Near Liverpool, UK. L39 2EL. 4. Specialist Orthodontist, Windmill Orthodontics, 37 Heaton Road, Newcastle upon Tyne, UK. NE6 1SB. 5. Post-CCST Orthodontist, Birmingham Dental Hospital, Mill Pool Way, Birmingham, United Kingdom. B5 7EG. 6. Post-CCST in Orthodontics, Charles Clifford Dental Hospital, 76 Wellesley Road, Sheffield, UK, S10 2SZ. 7. Specialist Orthodontist, Dungarvan Orthodontic Practice, Priory House, Main St., Dungarvan, Co. Waterford, Ireland. 8. Clinical Senior Lecturer in Orthodontics, Centre for Oral Health Research, Newcastle University, Framlington Place, Newcastle upon Tyne, UK. NE2 4BW.
Abstract
INTRODUCTION: Given the limited evidence about the benefits of orthodontic treatment, many health care systems have rationed access to orthodontic care with the Index of Orthodontic Treatment Need (IOTN) being one tool used to attempt to allocate resources based on need. However, it is not clear whether patient and public valuations of different levels of need (as described by the IOTN) reflect the resource allocation decisions. The aim of this project was therefore to determine the values parents placed on correction of malocclusions at different IOTN levels using the willingness to pay (WTP) technique. METHOD: 401 parents of children attending hospital-based orthodontic clinics in the North of England were recruited to complete a questionnaire eliciting WTP for the correction of seven malocclusions with different IOTN scores. In addition demographic and orthodontic history characteristics were collected. Results were analysed with appropriate pairwise significance tests and regression. RESULTS: A significant difference in WTP was noted between all the possible pairs of malocclusions with the exception of overjets with moderate versus great need of treatments. At moderate levels, correction of crowding was valued less than overjet but this was reversed at great need levels. Very little of the variance in WTP was explained by the variables collected. When looking at factors affecting percentage difference between values for different pairs of malocclusions, in general, no factors predicted the magnitude of difference. CONCLUSION: Median valuations for correction of malocclusions vary significantly for different levels of need (as judged by IOTN), with increasing levels of need generating higher values. However, there was a limited effect of demographic or orthodontic characteristics on the magnitude of percentage difference in values for correcting malocclusions different levels of need.
INTRODUCTION: Given the limited evidence about the benefits of orthodontic treatment, many health care systems have rationed access to orthodontic care with the Index of Orthodontic Treatment Need (IOTN) being one tool used to attempt to allocate resources based on need. However, it is not clear whether patient and public valuations of different levels of need (as described by the IOTN) reflect the resource allocation decisions. The aim of this project was therefore to determine the values parents placed on correction of malocclusions at different IOTN levels using the willingness to pay (WTP) technique. METHOD: 401 parents of children attending hospital-based orthodontic clinics in the North of England were recruited to complete a questionnaire eliciting WTP for the correction of seven malocclusions with different IOTN scores. In addition demographic and orthodontic history characteristics were collected. Results were analysed with appropriate pairwise significance tests and regression. RESULTS: A significant difference in WTP was noted between all the possible pairs of malocclusions with the exception of overjets with moderate versus great need of treatments. At moderate levels, correction of crowding was valued less than overjet but this was reversed at great need levels. Very little of the variance in WTP was explained by the variables collected. When looking at factors affecting percentage difference between values for different pairs of malocclusions, in general, no factors predicted the magnitude of difference. CONCLUSION: Median valuations for correction of malocclusions vary significantly for different levels of need (as judged by IOTN), with increasing levels of need generating higher values. However, there was a limited effect of demographic or orthodontic characteristics on the magnitude of percentage difference in values for correcting malocclusions different levels of need.
Entities:
Keywords:
Demographics; Economics; Index of Orthodontic Treatment Need; Orthodontics; Patient Preference; Social Values
Authors: Christopher R Vernazza; John R Wildman; Jimmy G Steele; John M Whitworth; Angus W G Walls; Ross Perry; Roger Matthews; Petra Hahn; Cam Donaldson Journal: J Dent Date: 2015-06-06 Impact factor: 4.379