Assessment of asthma patients' willingness to pay for and give time to an asthma self-management program

Despite the success of health education programs for patients with asthma, several researchers have found that patients are reluctant to enroll in and complete a program designed to help them manage their condition. The purpose of this study was to identify factors that influence asthma patients' willingness to pay (WTP) for and willingness to give time (WTGT) to an asthma self-management program. The patient sample consisted of 116 adult asthma patients (age range, 18 to 34 years) from 2 affiliated sites: a county teaching hospital with ambulatory clinics and a staff-model health maintenance organization. To determine WTP and WTGT, patients were presented with a scenario in which the components of an 8-week asthma management program were described. Patients were then asked how much they would be willing to pay for and how much time they would be willing to spend on the program. Regression analyses were used to determine what effect the following factors had on WTP and WTGT with respect to an asthma self-management program: sociodemographic factors; predisposing, enabling, and reinforcing factors; level of asthma self-management; and health care utilization. Mean patient WTP was $29.50 for an 8-week asthma education program. Several factors appeared to influence this amount. Patients who were willing to pay more for a program that would help them manage their asthma exhibited suboptimal behaviors during asthma attacks, had greater perceived access to health care resources, received less educational information from health care providers, had previously participated in a self-management program, and had indicated an interest in participating in a self-management program. This model was statistically significant (P < 0.0001), with 35% of the variation in WTP scores explained by the independent variables. Patients reported that they were willing to spend a mean of 5.8 hours per week on an 8-week asthma self-management program. Patients who were willing to spend more time on an asthma self-management program had indicated an interest in participating in such a program, had a higher number of comorbidities, or had more emergency department visits. This model was statistically significant (P = 0.0018), with 18% of the variance explained. This study identified several factors that may affect WTP and WTGT in relation to an asthma selfmanagement program. This information may be helpful in identifying candidates for educational programs.