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• W2552658596 abstract "<h3>Importance</h3> Specialty emergency departments (EDs) provide a unique mechanism of health care delivery, but the value that they add to the medical system is not known. Evaluation of patient preferences to determine value can have a direct impact on resource allocation and direct-to-specialist care. <h3>Objective</h3> To assess the feasibility of contingent valuation (CV) methodology using a willingness-to-pay (WTP) survey to evaluate specialty emergency services, in the context of an ophthalmology- and otolaryngology-specific ED. <h3>Design, Setting, and Participants</h3> Contingent valuation analysis of a standalone otolaryngology and ophthalmology ED. Participants were English-speaking adults presenting to a dedicated otolaryngology and ophthalmology ED. The WTP questions were assessed using a payment card format, with reference to an alternative modality of treatment (ie, general ED), and were analyzed with multivariate regression. <h3>Intervention</h3> Validated WTP survey administered from October 14, 2014, through October 1, 2015. <h3>Main Outcomes and Measures</h3> Sociodemographic data, level of distress, referral data, income, and WTP. <h3>Results</h3> A total of 327 of 423 (77.3%) ED patients responded to the WTP survey, with 116 ophthalmology and 211 otolaryngology patients included (52.3% female; mean [range] age, 46 [18-90] years). The most common reason for seeking care at this facility was a reputation for specialty care for both ear, nose, and throat (80 [37.9%]) and ophthalmology (43 [37.1%]). Mean WTP for specialty-specific ED services was $377 for ophthalmology patients, and $321 for otolaryngology patients ($340 overall; 95% CI, $294 to $386), without significant difference between groups (absolute difference, $56; 95% CI, $−156 to $43). Self-reported level of distress was higher among ear, nose, and throat vs ophthalmology patients (absolute difference, 0.47 on a Likert scale of 1-7; 95% CI, 0.10 to 0.84). Neither level of distress, income, nor demographic characteristics influenced WTP, but patients with higher estimates of total visit cost were more likely to have higher WTP (β coefficient, 0.27; SE, 0.05; adjusted<i>R</i>² = 0.17 for model). <h3>Conclusions and Relevance</h3> Patients with eye and ear, nose, and throat complaints place a mean explicit value on specialty emergency services of $340 per visit, relative to general emergency care. Ultimately, CV data using WTP methodology are useful in valuing patient preferences in monetary terms and can help inform state-wide resource allocation and the availability of direct-to-specialist care." @default.
• W2552658596 created "2016-11-30" @default.
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• W2552658596 date "2017-03-01" @default.
• W2552658596 modified "2023-10-14" @default.
• W2552658596 title "Contingent Valuation Analysis of an Otolaryngology and Ophthalmology Emergency Department" @default.
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• W2552658596 doi "https://doi.org/10.1001/jamaoto.2016.3267" @default.
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