ArticleBMJ open2025
What influences individual preferences for responsiveness in oral health services? A discrete choice experiment in Türkiye.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study aims to evaluate individual preferences that influence responsiveness in oral healthcare services through a discrete choice experiment (DCE), and to estimate the marginal willingness to pay (MWTP) associated with each attribute.
designSix key attributes influencing responsiveness in oral health services were identified and refined through a literature review, pilot testing and expert consultation: clinic cleanliness, dentist specialisation, dentist attitude, clarity of explanation, treatment initiation time and contribution fee. To enable independent (orthogonal) estimation of attribute effects, minimise confounding due to interactions and ensure balanced representation of factor levels, an orthogonal fractional factorial design was employed to construct the DCE questionnaire. Data were collected using paper-based questionnaires, and MWTP estimates were derived from the resulting regression coefficients.
settingThe DCE was conducted at Hacettepe University's Beytepe Campus in Ankara, Türkiye, between April and May 2024.
participants375 administrative staff actively work at Hacettepe University's Beytepe Campus.
main outcome measuresA conditional logit model was used to estimate preferences and MWTP for different attribute levels.
resultsThe attribute with the highest MWTP was the provision of specialised oral health services ($12.26), followed by clinic cleanliness, a concerned dentist, timely treatment initiation, clear explanations provided by the dentist and contribution fee. Upon incorporating interaction terms-namely age, gender, equivalised disposable income, preferred clinic type and alcohol use-significant variations in preferences were observed across subgroups.
conclusionsPolicy responsiveness in oral healthcare requires identifying prioritised non-clinical service attributes. Policymakers must integrate this evidence into resource allocation and service planning. DCEs across diverse populations are essential for adapting service delivery to evolving public priorities and optimising care quality.
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