Determinant of willingness-to-pay among patients with musculoskeletal disorders: a cross-sectional survey

Fatoye, Francis ORCID: https://orcid.org/0000-0002-3502-3953, Mbada, Chidozie ORCID: https://orcid.org/0000-0003-3666-7432, Olowodasa, Miriam, Gebrye, Tadesse ORCID: https://orcid.org/0000-0001-7976-2013, Fatoye, Clara Toyin, Olufemi, Oyeleye and Idowu, Opeyemi Ayodiipo (2025) Determinant of willingness-to-pay among patients with musculoskeletal disorders: a cross-sectional survey. Advances in Public Health, 2025 (1). 537721. ISSN 2356-6868

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Abstract

Background The economic burden of musculoskeletal disorders (MSDs) is significant and will grow with increasing aging population. Objectives To assess willingness-to-pay (WTP) and its determinants for patients with MSDs with a view to ascertaining true demand for healthcare and its correlates. Methods A cross-sectional survey of consenting physiotherapy outpatients was carried out. Sixty-eight (female = 52.9%) consecutive adult patients with MSDs receiving physiotherapy. Health-related quality of life (QoL), patients’ satisfaction and WTP were assessed using the general health status SF-12 questionnaire, physical therapy patient satisfaction survey (PTPS) and WTP questionnaire, respectively. Results The mean age of the patients was 51.6 ± 19.4 years. The highest and lowest WTP were found in manual therapy (91.2%) and electrical muscle stimulation (0%), respectively. The highest “no WTP” was found among females and middle socioeconomic status across all physiotherapy modalities. Ethnicity and previous exposure to physiotherapy modality significantly predicted WTP (p  < 0.05). Those of “Yoruba” ethnicity compared with others were 98.3% less likely to have WTP for cryotherapy (OR = 0.017; CI = 0.001–0.347; p = 0.008). Those who had previous experience of exercise treatment were 329 times more likely to have WTP for exercise than those who had not (OR = 329.02; CI = 23.60–4586.89; p = 0.001). Those who had previous treatment with electrical muscle stimulation were 11 times more likely to have WTP for cryotherapy (OR = 11.50; CI = 1.12–117.89; p = 0.04). Conclusion WTP for physiotherapy among patients with MSDs varies according to treatment modality, prior exposure, and sociodemographic characteristics, with manual therapy most valued and electrical stimulation least preferred. These findings provide insight into patient preferences that may inform the design and delivery of more equitable and contextually relevant rehabilitation services.