Beneficiaries’ Willingness to Pay for Resuscitation Provided by Ambulance Attendants: A Survey Using the Contingent Valuation Approach
- 1 Department of Public Health, Health Management and Policy, Nara Medical University, Nara, Japan
- 2 Department of Public Health, Health Management and Policy, Nara Medical University, Nara, Japan
- 3 Department of Public Health, Health Management and Policy, Nara Medical University, Nara, Japan
- 4 Department of Health and Welfare and Health Service Management, International University of Health and Welfare, Tokyo, Japan
- 5 Department of Public Health, Health Management and Policy, Nara Medical University, Nara, Japan
Abstract
Background: Japanese emergency medical services (EMS) can be used by anyone for free. Recently, EMS usage has increased; the increased costs and the prolonged time for ambulance transport have become recent social problems. Objective: We surveyed the willingness to pay (WTP) for resuscitation provided by EMS. Methods: In November 2011, men and women (3160) aged 20 - 59 years were asked to assume that they were experiencing a cardiopulmonary arrest (CPA), and their WTP for EMS services was assessed in the following three situations: Case A, ambulance transport alone; Case B, chest compression in addition to ambulance transport; and Case C, artificial ventilation through chest compression and intratracheal intubation, in addition to ambulance transport. We calculated the mean WTP for each case. Results: The WTP for Case A, B, and C were ¥6,696 ($65.0), ¥16,081 ($156.1), and ¥27,505 ($267.0), respectively. The WTP for Case B was significantly higher in respondents aged 40 - 59 years compared to those aged 20 - 39 years. The WTP for case B and C were significantly higher in males compared to females. WTP was significantly lower in students than it was in private employees. Although women’s intention to pay was higher than that of men, their WTP was lower than that of men. Public employees’ and students’ intention to pay was significantly lower than that of private employees. Conclusions: Our study provides information about the optimal fee for EMS, which will be useful for discussions on the feasibility of introducing a fee for EMS in Japan.
- Official Statement by Fire and Disaster Management Agency, Government of Japan. 2014. (In Japanese) http://www.fdma.go.jp/html/hakusho/h27/h27/html/2-5-1-1.html
- SOS-KANTO 2012 Study Group (2015) Changes in Pre- and In-Hospital Management and Outcomes for Out-Of-Hospital Cardiac Arrest between 2002 and 2012 in Kanto, Japan: The SOS-KANTO 2012 Study. Acute Medicine & Surgery, 2, 225-233. https://doi.org/10.1002/ams2.102
- Tanigawa, K. and Tanaka, K. (2006) Emergency Medical Service System in Japan: Past, Present, and Future. Resuscitation, 69, 365-370. PMID: 16740355. https://doi.org/10.1016/j.resuscitation.2006.04.001
- Kitamura, T., Iwami, T., Kawamura, T., Nishiyama, C., Sakai, T., Sugihara, K., Sasaki, M., Kajino, K., Irisawa, T., Hayashida, S., Nishiuchi, T. and Hiraide, A. (2014) Ambulance Calls and Prehospital Transportation Time of Emergency Patients with Cardiovascular Events in Osaka City. Acute Medicine & Surgery, 1, 135-144. https://doi.org/10.1002/ams2.25
- Official Statement by Fire and Disaster Management Agency, Government of Japan. 2015. (in Japanese) http://www.fdma.go.jp/html/hakusho/h27/h27/html/2-5-2-3.html?words=%E6%95%9 1%E6%80%A5%E6%95%91%E5%91%BD%E5%A3%AB
- Akahane, M., Ogawa, T., Koike, S., Tanabe, S., Horiguchi, H., Mizoguchi, T., Yasunaga, H. and Imamura, T. (2011) The Effects of Sex on Out-Of-Hospital Cardiac Arrest Outcomes. The American Journal of Medicine, 124, 325-333. PMID: 21435423. https://doi.org/10.1016/j.amjmed.2010.10.020
- Ogawa, T., Akahane, M., Koike, S., Tanabe, S., Mizoguchi, T. and Imamura, T. (2011) Outcomes of Chest Compression Only CPR versus Conventional CPR Conducted by Lay People in Patients with out of Hospital Cardiopulmonary Arrest Witnessed by Bystanders: Nationwide Population Based Observational Study. BMJ, 342, c7106. PMID: 21273279. https://doi.org/10.1136/bmj.c7106
- Akahane, M., Tanabe, S., Ogawa, T., Koike, S., Horiguchi, H., Yasunaga, H. and Imamura, T. (2013) Characteristics and Outcomes of Pediatric Out-Of-Hospital Cardiac Arrest by Scholastic Age Category. Pediatric Critical Care Medicine, 14, 130-136. PMID: 23314182. https://doi.org/10.1097/PCC.0b013e31827129b3
- Official Statement by Fire and Disaster Management Agency, Government of Japan. 2014. (In Japanese) http://www.fdma.go.jp/html/hakusho/h27/h27/html/2-5-1-2.html
- Camasso-Richardson, K., Wilde, J.A. and Petrack, E.M. (1997) Medically Unnecessary Pediatric Ambulance Transports: A Medical Taxi Service? Academic Emergency Medicine, 4, 1137-1141. PMID: 9408429. https://doi.org/10.1111/j.1553-2712.1997.tb03696.x