Baseline Characteristics and Treatment Preferences of Oral Surgery Patients

Atchison, Kathryn A.; Gironda, Melanie W.; Black, Edward E.; Schweitzer, Stuart; Der-Martirosian, Claudia; Felsenfeld, Alan; Leathers, Richard; Belin, Thomas R.

doi:10.1016/j.joms.2007.04.011

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 12 , Pages 2430-2437, December 2007

Baseline Characteristics and Treatment Preferences of Oral Surgery Patients

Kathryn A. Atchison, DDS, MPH
- Professor, University of California Los Angeles (UCLA) School of Dentistry, Los Angeles, CA.
- Address correspondence and reprint requests to Dr Atchison: UCLA School of Dentistry, Box 951668, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
Melanie W. Gironda, PhD, MSW
- Adjunct Assistant Professor, UCLA School of Dentistry, Los Angeles, CA.
Edward E. Black, DDS, MS
- Associate Professor, Charles R. Drew University of Medicine and Science, Los Angeles, CA.
Stuart Schweitzer, PhD
- Professor, UCLA School of Public Health, Los Angeles, CA.
Claudia Der-Martirosian, PhD
- Biostatician, UCLA School of Dentistry, Los Angeles, CA.
Alan Felsenfeld, DDS, MA
- Professor, UCLA School of Dentistry, Los Angeles, CA.
Richard Leathers, DDS
- Associate Professor, Charles R. Drew University of Medicine and Science, Los Angeles, CA.
Thomas R. Belin, PhD
- Professor, UCLA School of Public Health, Los Angeles, CA.

Purpose

Patient preferences for treatment choices may depend on patient characteristics. Using standard gamble (SG) and willingness to pay (WTP), this study compares preferences for treatment of mandibular fracture among patients in a low-income urban area.

Patients and Methods

Surveys of African-American and Hispanic adults receiving treatment at King/Drew Medical Center for either mandibular fracture (n = 98) or third molar removal (n = 105) were used to investigate differences in patient characteristics across treatment groups (third molar vs fracture) and treatment preference (wiring vs surgery).

Results

The fracture patients were willing to pay more to restore function without scarring or nerve damage than were the third molar patients. Patients who chose surgery were willing to accept a greater risk of possible nerve damage or scarring than those who chose wiring. Among 15 potential predictors of SG and WTP studied in 4 subgroups defined by actual treatment and treatment preference, significant predictors varied, with associations for education and clinical experience for SG and associations with income and psychosocial predictors for WTP.

Conclusions

SG and WTP capture different domains of health values in patients. There is considerable heterogeneity in relationships among patient characteristics and patient preferences across subgroups defined by actual treatment and treatment preferences.