RESUMO
BACKGROUND: Neurologic disorders impose a heavy burden on healthcare in Singapore. To date, no data on the willingness to pay (WTP) for neurologic treatments has been reported in the local population. OBJECTIVES: We aimed to quantify the value of various health domains to neuroscience patients and their caregivers by comparing their WTP for different types of treatments. METHODS: A questionnaire using a mixed open-ended and closed-ended contingent valuation method was developed to elicit WTP and self-administered by 112 visitors to a neuroscience outpatient clinic. The WTP for treatments in 3 health domains (advanced restoration of function, life extension, and cosmesis) was evaluated and compared. Subgroup regression analysis was performed to investigate the impact of demographic and socioeconomic factors. RESULTS: Treatment that improved cosmesis had the highest median WTP of Singapore dollar (SGD) 35 000, followed by treatment that provided 1 year of life extension (SGD 20 000) and 1 year of advanced restored function (SGD 10 000; P < .001). Respondents with a university education were willing to pay as much as 2 to 3 times of those without across all health domains. CONCLUSION: This is the first study to provide data on how different health domains are valued by neuroscience patients and caregivers in our population. Respondents valued treatment that restored or improved their physical appearances the most. These findings could contribute to future policies on the improvement of neuroscience care.
Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Cuidadores/psicologia , Neurociências/métodos , Pacientes/psicologia , Recuperação de Função Fisiológica/fisiologia , Adulto , Instituições de Assistência Ambulatorial/economia , Instituições de Assistência Ambulatorial/organização & administração , Cuidadores/estatística & dados numéricos , Análise Custo-Benefício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurociências/economia , Neurociências/tendências , Pacientes/estatística & dados numéricos , Anos de Vida Ajustados por Qualidade de Vida , Singapura , Fatores Socioeconômicos , Estatísticas não Paramétricas , Inquéritos e QuestionáriosRESUMO
A recurrent right temporal glioblastoma that vanished on MRI after a short course of intense corticosteroid therapy is reported. This was associated with development of new multicentric lesions in the right frontal lobe and right splenium of the corpus callosum. Rapid disappearance of tumor with steroid therapy is frequently associated with lymphoma and is rarely described in high-grade gliomas. Literature review showed that multicentricity and involvement of the corpus callosum are common features of glioblastoma that vanish after corticosteroid therapy.