Who Are the People Willing to Pay for Physician Home Visits?

Abstract

Background: Since the recently announced Community Care Policy, there has been an opinion that Korea needs to establish an alternative medical model such as physician home visits. This study aimed to assess the need and willingness to pay (WTP) for physician home visits among the community-dwelling Korean older population and to determine the most important factors that influence older adults to decide to use a physician home visit service. Methods: A total of 797 people aged 60 years or older who were randomly selected from a nationwide dataset using a multi-stage stratified sampling method answered a questionnaire on the need and WTP for physician home visits. Results: A total of 39.3% of participants reported that they would like a physician home visit when they need help. Among older adults who needed physician home visits (n = 313), the WTP amount for physician home visits was 21,982 ± 17,546 KRW. Logit and Tobit regression analyses showed that the higher valuated need and WTP for physician home visits was associated with a lower level of physical/psychosocial functioning measured by EuroQol-five dimensions score (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.01–1.27; P = 0.035) and a higher level of satisfaction when using community-based services such as public health centers (OR, 1.32; 95% CI, 1.02–1.72; P = 0.034), social welfare centers and Gyeong-ro-dang (OR, 1.61; 95% CI, 1.04–2.50; P = 0.033; β = 8.39; standard error, 3.63; P = 0.021). Conclusion: This study provides evidence that the decision to pay for a physician home visit service is based upon the complex interactions among an individual's physical and psychosocial functioning, personal experiences of service utilization, and demographic factors. The value for physician home visits should be qualified based on the empirical data of WTP, which comes from a consumer-centered perspective.