Satisfaction, utilization, and willingness to pay for primary care services

Abstract

This thesis investigates the nature of stated and revealed preferences on the part of the public for primary care services. It examines the relationship between satisfaction, willingness-to-pay (WTP), and use of primary care services in Britain and Saudi Arabia. The thesis used three measures to triangulate these concepts: satisfaction, WTP, and utilisation of primary care services. Satisfaction provided an ordinal measure of stated preference, while WTP provided a cardinal measure of stated preference. Use (utilisation) provided a measure of revealed preference. Using these measures across various contexts, the thesis explores how preferences and the relationships between preferences and respondent characteristics vary depending on the context and the measure used. The thesis findings indicate that satisfaction, WTP, and use of primary care services provide distinct but complementary insights into variations in preferences between socio-demographic groups; points in time; regions and; the location in which data are collected. Observed variations are grounded in a variety of factors that include needs and the nature of service provision. The thesis provides an appreciation of the complexity of stated and revealed preferences and the challenges inherent in using such data to inform policy using examples drawn from Britain and Saudi Arabia and identifies a number of avenues for future research in this area.