2021, Number 2
The impact of reporting on biosecurity measures to face COVID-19 on patients' willingness to pay (WTP) an extra amount for dental visits
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Language: English/Spanish [Versión en español]
References: 14
Page: 130-135
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ABSTRACT
Objective: To estimate the patients' willingness to pay (WTP) an extra amount for a dental visit, knowing that the clinic implemented biosecurity measures to avoid COVID-19 spreading and if this willingness is modified by offering them more information about the measures and their implementation costs. Material and methods: To pose to people in Mexico City a hypothetical scenario through surveys and to apply a test of means. Results: 45% of respondents would be WTP an additional amount for a dental visit. That number could rise to 58% if more information is provided. Conclusions: The presence of COVID-19 has had a strong economic effect on dental practices. Public policy makers should design and implement financial support for the health sector. In turn, the latter should offer more information about the advantages of the measures and the costs of implementing them.INTRODUCTION
The novel coronavirus disease (SARS-CoV-2) better known as COVID-19, is associated with a severe acute respiratory illness, having the first human case in Wuhan, China, in late 2019 and rapidly spreading throughout the world during 2020.1 By February 2020, the COVID-19 pandemic had infected approximately 112 million people and caused 2.4 million deaths worldwide.2 Besides the lives lost and the collapse of health systems around the world, fighting COVID-19 also involved social challenges3 that have caused global instability, mainly in terms of economic activity.4-6
Meanwhile, health care practices should be prepared to address dental needs even during a pandemic such as the one presented by COVID-19.7,8 Offering adequate health care under the current pandemic context requires to dentists and health centers to adopt a new biosecurity equipment and more specific decontamination protocols to ensure safe practices.9,10 However, in addition to the fact that the number of dental visits has dropped during the pandemic, improving biosecurity practices significantly increases the costs.7,11 Likewise, patients should be informed and aware that this could lead to different prices for different treatments.12-14
This paper aims to analyze - through a hypothetical scenario posed in surveys applied to people in Mexico City- the willingness to pay (WTP) an additional amount for a dental visit, knowing that the clinic they attend implemented strict biosecurity measures to avoid COVID-19 spreading. In the same way, find out if this WTP changes if the person has additional information or not about these measures and the costs of implementing them.
MATERIAL AND METHODS
Data: the data was obtained using the survey named "C19&CO" (whose Spanish meaning is COVID-19 and dental visit) which was online from September to November 2020 through a digital platform. The database is made up of 423 surveys, which was a statistically representative sample (95%) of residents in Mexico City, with 5% margin of error.
Scenario: the hypothetical scenario posed to the respondents was that they needed attend a dental visit, and if they would be WTP an additional amount knowing that the clinic they attend had implemented biosecurity measures to avoid COVID-19 spreading. Then they were asked if their decision could change if they were provided with more information about the measures and the costs to implement those measures. Finally, the surveys were randomly divided according to three treatments: i) caries for which an appointment with a general dentist should be made, ii) untreated caries that led to a root canal treatment, for which an endodontist should be consulted, and iii) orthodontic treatment (Figure 1).
Since the cost of a dental visit is different according to the treatment, previously (from June to July) 250 surveys were applied to dentists in Mexico City to inquire about those costs, the biosecurity measures adopted and the costs of their implementation.
Analysis of the information: the WTP decisions were analyzed through the test of means applying the χ2 test, with a significance level of 0.05; the program Stata version 14 was used.
RESULTS
It was found that approximately 32% of the respondents would cancel their dental visit due to fear of contagion. 44.9% would be WTP an additional fee for dental visits, knowing that the clinic implemented strict biosecurity measures. It is interesting that said opinion changes statistically depending on the type of treatment analyzed (p <0.001).
In case of an orthodontist visit, 37.7% of the respondents would be WTP an additional fee, taking into account that it is a longer treatment and that they would already have a fixed amount previously budgeted. In case of an appointment for the treatment of a cavity, 41.7% would be WTP an additional amount. In case of an appointment for a root canal treatment, 54.1% would be WTP (Figure 2). Finally, the increase monetary amount that the respondents would be WTP for a dental visit ranged from 23 to 41%, depending on the type of the treatment (p < 0.001) (Figure 2).
It is important to mention that the C19&CO survey offered an alternative to the scenarios previously exhibited. It consisted of providing more prior information on the biosecurity measures implemented by the clinics, and the cost for implementing them. Providing that information increased from the amount of respondents who would be WTP an additional cost for a dental visit from 44.9 to 57.7% (p < 0.001). When inquiring about opinion shift according to the different types of appointments, it was observed that the greatest impact of having additional information corresponded to the respondents group who would have to attend an appointment for a root canal treatment, shifting from 54.1 to 76.7% (p < 0.001).
In other words, it is evident that having prior information about the importance of biosecurity measures and their respective costs impacted positively on the WTP of those surveyed, who surely felt that the payment increase could reduce the risk of COVID-19 and therefore they would get greater wellbeing (Figure 2).
CONCLUSIONS
The novel coronavirus disease (SARS-CoV-2) better known as COVID-19, was declared a pandemic (WHO) on March 11, 2020 by the World Health Organization. It has infected roughly 112 million people, causing 2.4 million deaths worldwide. The pandemic has changed socio-economic dynamics including dental sector, due to the reduction in the number of dental visits, as well as the increase in costs of supplies and in biosecurity measures implementing.
This paper, carried out through surveys applied to Mexico City people, shows that approximately 32% of the respondents would cancel their dental visit due to the presence of COVID-19; almost 45% would be WTP an extra amount for dental visits, if the office or clinic they attend implements biosecurity measures, and it would increase up to 58% if the respondents have more detail of the measures implemented, advantages and disadvantages, and costs incurred.
Although patients would be WTP an extra amount for their dental visit and some dentists already invest in such biosecurity measures, governments and dental health regulatory bodies in countries must understand the situation seriousness and offer some kind of support for dental practices. For example, on March 18, 2020, the Canadian government established an Economic Response Plan to support businesses and allocated approximately C $ 27 billion to support them, including those working in health area, such as clinics and dental offices.11
The COVID-19 pandemic totally changed people's lives and the ways of production in economy. In this sense, the different economic sectors, such as dentistry, should adapt themselves to such a situation by incorporating the best biosecurity alternatives, benefiting both their workers and their consumers, making known the patients the private costs and social advantages for implementing them.
REFERENCES
Rodríguez-Izquierdo E, Pérez-Jiménez S, Merino-Pérez L, Mazari-Hiriart M. Spatial analysis of COVID-19 and inequalities in Mexico City. Insights by CDP members on the COVID-19 crisis. Department of Economic and Social Affairs. 2020. Available in: https://www.un.org/development/desa/dpad/wp-content/uploads/sites/45/COVID-19-Mexico-City.pdf
Chamorro-Petronacci C, Carreras-Presas CM, Sanz-Marchena A, Rodríguez-Fernández MA, Suárez-Quintanilla JM, Rivas-Mundiña B et al. Assessment of the economic and health-care impact of COVID-19 (SARS-Co V-2) on public and private dental surgeries in Spain: a pilot study. Int J Environ Res Public Health. 2020; 17 (14): 5139.
Wanderley-Cavalcanti Y, Oliveira da Silva R, de Freitas-Ferreira L, Gomes de Lucena EH, Luzia-Baldo de Souza AM, Barros-Cavalcante DF et al. Economic impact of new biosafety recommendations for dental clinical practice during COVID-19 pandemic. Pesqui Bras Odontopediatria Clin Integr. 2020; 20 (suppl 1): e0133.
AFFILIATIONS
1 CONACyT-UAM, Área de Crecimiento y Medio Ambiente, Departamento de Economía, Universidad Autónoma Metropolitana, Unidad Azcapotzalco. Ciudad de México, México.
2 Dent-All. Ciudad de México, México.
Conflict of interest: The authors declare no conflict of interest related to the publication of this article.
Funding: This article was prepared with the financial support of the Consejo Nacional de Ciencia y Tecnología (CONACYT) through the Programa IxM - Investigadoras e Investigadores por México del CONACYT No 1812.
CORRESPONDENCE
Daniel Alfredo Revollo-Fernández. E-mail: drevollofer@gmail.com, darevollof@conacyt.mxReceived: Abril 2021. Accepted: Septiembre 2021.