Date of Award

1-13-2021

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Muhammad Ashar Malik

Second Advisor

Dr. Wafa Aftab

Third Advisor

Dr. Wajeeha Zahid

Department

Community Health Sciences

Abstract

Background: Prevalence of Dental Caries is 50-90% globally, 40-84% regionally and 44-70% in Pakistan. Dentist and patients have long been confronted with the questions such as whether a tooth should be saved with the help of a Root Canal Treatment and restoration or extracted. According to WHO, dental treatment is the fourth most expensive treatment even in industrialized countries. Dental treatment on average accounts for 5% of the Total Health Expenditure and 20% of OOP expenditure even in HIC. There is no oral health policy in Pakistan which indicates the low priority given to oral health in the country.
Objective: The study objective was “to estimate patients’ willingness-to-pay for Tooth extraction versus Manual and Rotary Endodontic treatment in private dental facility in Karachi.”
Methods: The study design utilized was Cross- sectional with non-probability purposive sampling technique. 166 participants were recruited from a private dental facility in Karachi and interviewed. They were given a hypothetical scenario of a tooth with poor prognosis and asked the amount they were willing to pay for the treatment with a starting bid of 100/- for extraction. 5800 for manual Root Canal Treatment and 8000/- for rotary Root Canal Treatment. Demographic data, Association of WTP with different variables (Student t-test, One-way ANOVA) and association between qualitative variables (chi-square test) were revealed.
Results: The mean WTP for extraction was found to be PKR 2700/- (15.47 US$), PKR- 7,268/- (41.65 US$) for manual RCT and PKR- 15,500/- (88.83US$) for rotary RCT. The WTP values were significantly associated with type of employment, monthly expenditure, who are the participants financially dependent on, importance of oral hygiene, frequency of brushing and the experience of last treatment (p values 0.05). In our study we did not find an association of WTP with Gender, Education, marital status, prior dental treatment experience, last visit to the dentist and reason of the last visit.
Conclusion: In our study the WTP recorded is higher than the market average charges of all three interventions. The awareness regarding oral health is increasing in our country but at a very slow pace. People reported that oral health is important but rarely visit a dentist for annual check-ups. The benefits of preventive dentistry are still not understood among the general population. Most of the participants preferred to save their tooth (94%) and majority were well aware regarding oral hygiene importance (51.8%). In the past, medical and dental treatment decision making was made unilaterally by physicians, but in the recent years, patients have shown a keen interest in being involved in decisions about healthcare and take an active part in the decision-making process. The clinician provides all relevant information to the patient who then happens to make an informed decision according to their circumstances and previous experiences.

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1

Last Page

95

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