Aanesthetic Agents for Day Surgery - NIHR Health Technology ...

208
Appendix 16
Five patients gave protest values and said:
“I won’t pay on principle – healthcare should be
free at point of delivery” [agyfa1063, willingness to
pay £0].
These values (12% propofol/propofol, 8%
propofol/isoflurane, 10% propofol/sevoflurane,
12% sevoflurane/sevoflurane) were excluded from
the main analysis of the willingness-to-pay values
(see chapter 6).
Table 81 shows the reasons patients gave for their
stated willingness-to-pay values. Patients mainly said
they were stating their strength of preference for
avoiding the mask or injection:
“I really do not like needles and would do a lot to
avoid one” [agnmc147, willingness to pay £250]
or indicating how much they wanted the mask
or injection:
“... because I am expressing my high satisfaction with
treatment” [agnmc043, willingness to pay £200].
Some patients did not have a strong preference
for the method of induction and would have the
other option if that was offered:
“... because although I have a minor preference, it is
minor and if I had to have the other then I would”
[agyfa161, willingness to pay £25].
Some patients did not give a reason, but said their
valuation reflected their strength of preference for
the chosen method of induction:
“... because that’s my personal feeling about how
much I’d prefer medicine A” [agyfs042, willingness
to pay £250].
Adult patients’ preferences for maintenance
Table 82 summarises the reasons behind the
patients’ stated preference for medicine D
compared to medicine C for the maintenance
of anaesthesia. The majority of patients chose
medicine D, which offered them less chance
of feeling or being sick. Three per cent of all
respondents (4% propofol/propofol, 2%
propofol/isoflurane, 4% propofol/sevoflurane,
2% sevoflurane/sevoflurane) stated a preference
for medicine C and a further two respondents
did not state a preference because they did not
understand the question. The associated
willingness-to-pay values were excluded
from the analysis in the empirical study.
Generally patients chose medicine D because they
identified there was less chance of being sick:
“... because 7/10 feel sick with C and 3/10 feel sick
with D” [agyfa1104].
Some patients felt strongly that they did not want
to be sick:
“Want best chance – being sick is horrible”
[aormc076].
Patients’ strength of preference for maintenance of
anaesthesia with a lower chance of feeling or being
sick was quantified using willingness to pay (see
chapter 4). Some respondents (7% propofol/
propofol, 6% propofol/isoflurane, 6% propofol/
sevoflurane, 7% sevoflurane/sevoflurane) did not
understand the question and used the values like a
VAS and five respondents stated a protest value of
£0. These values were excluded from the analysis in
the empirical study. Table 83 shows the reasons given
for the stated willingness-to-pay values.
Patients’ strength of preference for medicine D
reflected that they did not like being sick:
“If it makes me feel less sick I’d put a lot of value
on that. I felt really sick” [agnmc007, willingness to
pay £250].
Interestingly, most patients said they did not value
not being sick as strongly as their choice of
induction agent:
“I do not think it is as important, feeling sick. It is not
something I am scared of and I could put up with it”
[agyfs032, willingness to pay £100].
Concluding remarks
Overall, parents, guardians or patients were more
likely to prefer the anaesthetic technique they
experienced in the empirical study than anaesthetics
they, or their child, may previously
have received.
The parents’ and guardians’ views and experiences
with the anaesthetics given to their children in this
study were very similar between the two treatment
arms. The main difference was that they were more
likely to have observed their child having propofol
induction in the past and their son/daughter
seemed less drowsy after this operation than in
previous experiences. Most patients, and parents
or guardians, were extremely satisfied with the