Factors Associated With Patient Willingness to Pay for Healthcare: A Systematic Review

OBJECTIVES: Willingness to pay (WTP) is a key component of health economic evaluations, particularly in assessing patient preferences and their implications for healthcare delivery and policy formulation. The associated factors of WTP for healthcare are influenced by a complex interplay of various factors but lack consensus. This systematic review aimed to bridge these gaps by consolidating existing research on the factors influencing patient WTP for healthcare services.

METHODS: A systematic review was conducted to identify all published studies reporting associated factors with patient WTP for healthcare according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Checklist. PubMed, Embase, Web of Science, Cochrane Library, and Centre for Reviews and Dissemination database were searched from inception to May 29, 2023. A quality assessment scoring scale was developed to evaluate the literature quality.

RESULTS: Ninety-nine eligible articles with 130 WTP values from 20,320 articles were included in the final review. The average quality score was 6.32 of 7. The articles were published over the period from 1984 to 2023, covering 29 countries. In total, nine categories were summarized from 41 influencing factors associated with WTP. These included individual-related factors, socio-economic factors, insurance factors, disease-related factors, social and psychological factors, personal health awareness, treatment-related factors, medical-related factors, and previous treatment. Most of the included studies indicated a positive correlation of WTP with income, education, disease severity, quality of healthcare, and previous treatment costs. Conversely, age, health utility, and treatment cost showed a negative correlation.

CONCLUSIONS: Despite some factors influencing WTP varying, this study summarized the correlations of different factors influencing WTP, providing valuable insights for future research design. Understanding such information is crucial for designing future health economic evaluation studies, developing health service plans, optimizing health resource allocation, and ultimately enhancing patient health outcomes in various healthcare systems and jurisdictions.