How much are patients willing to pay to avoid intraoperative awareness?

Tong J. Gan, Richard J. Ing, Guy De L Dear, David Wright, Habib E. El-Moalem, David Lubarsky

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Study Objective: To determine how much patients are willing to pay to avoid intraoperative awareness? Design: Observational study Setting: University-affiliated metropolitan hospital. Patients: 60 patients who completed a questionnaire (39 F, 21 M). The mean age was 43 years and the median household income range of US$45,000 -$60,000. Interventions: Patients completed an interactive computer-generated questionnaire on the value of preventing intraoperative awareness and their willingness to pay for a "depth of anesthesia" monitor. Their willingness to pay for the prevention of postoperative pain, nausea and vomiting, postoperative grogginess, and sleepiness was also determined as a means of comparison. Measurements and Main Results: Patients were willing to pay (WTP) $34, $10 to $42 (median, interquartile range) for a monitor that would assist an anesthesia care provider assess the depth of anesthesia in an effort to avoid awareness. This increased to $43, $20 to $77 (p < 0.0,001) (median, interquartile range), if the insurance company was making the payment and the WTP value only decreased minimally to $33 if the incidence of awareness was reduced 10-fold. Conclusion: The incidence of intraoperative awareness and WTP value for monitoring awareness have a nonlinear relationship (a risk averse utility function), which suggests that patients assign an intrinsic base value for a rare or very rare possibility of an event. Other healthcare economic analyses (such as cost effectiveness) do not take this factor into account and assume a linear value relationship (i.e., if something occurs ten times less frequently, it has ten times less value). Implication: The median value for patients' WTP for a monitor that might prevent awareness under anesthesia was $34 given an incidence of 5/1,000 cases. The incidence of awareness and WTP value have a nonlinear relationship suggesting that patients assign an intrinsic base value for the possibility of awareness.

Original languageEnglish (US)
Pages (from-to)108-112
Number of pages5
JournalJournal of Clinical Anesthesia
Issue number2
StatePublished - Jan 1 2003
Externally publishedYes


  • Cost-benefit analysis
  • Grogginess
  • Intraoperative awareness
  • Nausea
  • Pain
  • Vomiting
  • Willing to pay (WTP)

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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