Willingness to Pay for Preventive and Curative Dental Procedures in Malaysia: An Urban-Rural Analysis.

OBJECTIVES

To estimate willingness to pay (WTP) for selected preventive and curative dental procedures, identify demographic, socioeconomic and behavioural factors associated with WTP, and examine urban-rural differences among Malaysian adults.

METHODS

A cross-sectional study was conducted using a self-administered questionnaire based on the contingent valuation method. A total of 387 adults were recruited through multistage stratified sampling from UTC Selangor (urban) and UTC Keningau (rural). WTP was elicited for five preventive procedures (dental check-up, scaling and polishing, oral hygiene advice, fluoride varnish and fissure sealant) and two curative procedures (dental filling and extraction). Data were analysed using descriptive statistics, Mann-Whitney U tests and multiple linear regression.

RESULTS

Median (25th-75th percentile) WTP ranged from RM50 (RM20-RM100) for oral hygiene advice to RM130 (RM60-RM240) for dental filling. Median WTP was RM100 for dental check-up (RM35-RM150), scaling and polishing (RM50-RM160), fissure sealant (RM50-RM150) and dental extraction (RM50-RM172.50), and RM80 (RM40-RM130) for fluoride varnish application. Because the payment-card upper bounds differed across procedures, these between-procedure estimates should be interpreted as conditional on the ranges presented. Higher household income, medical and dental insurance coverage and regular dental attendance were positively associated with WTP across several procedures. In unadjusted analyses, urban participants reported significantly higher WTP for all seven procedures (p < 0.05); however, study location was not independently associated with WTP after adjustment.

CONCLUSIONS

Stated WTP varied across the selected dental procedures and was associated mainly with socioeconomic and behavioural factors. The higher observed median WTP for dental filling cannot establish that curative care is inherently valued more highly than preventive care because the procedure-specific payment-card ranges differed. The estimates should therefore be interpreted within the ranges presented.