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Willingness to pay and sharps injury


Clinical bottom line

Healthcare workers would be willing to spend substantial sums of their own money to prevent a sharps related injury. This measures intangible costs, and these are of the same magnitude as the costs of treating sharps related injury.


DN Finsman et al. Willingness to pay to avoid sharps-related injuries: a study in injured health care workers. American Journal of Infection Control 2002 30: 283-287.


Participants in this study were healthcare workers in two major centres in Boston and Baltimore who had reported a sharps-related injury with a contaminated medical device and who accepted an invitation from an occupational health service.Exposure without skin puncture was an exclusion.

Participants were provided with a hypothetical situation and asked to estimate their own willingness to pay for a nonmarket good. A monetary value could then be placed on intangible or abstract policy outcomes.

A take it or leave it approach was used. Subjects were asked the following question:

"Suppose there was a reusable device that could have prevented your injury. Knowing what you know now, would you have paid $X out of pocket for such a device?"

The value of $X was selected at random from a group of nine bids ranging in value from $10 to $5,000. Participants could answer yes or no whether they were willing to pay for the hypothetical device at the price quoted.


In the year to April 2001, 122 subjects were recruited and 116 participated. Most (70%) were women, and their average age was 34 years. Nurses were the biggest group (44%) followed by trainees (35%). The median time from injury to interview was three days (0-15 days).Most injuries (64%) were caused by a hollow-bore needle.

At $10, everyone would be willing to pay. At $50-$500, about 70% would be willing to pay. Above $500 the willingness to pay fell generally below 50%.

The median amount participants would be willing to pay was $850. Presented with the question in this form half would have been expected to agree to pay the cost of the device if it could have prevented their injury. A quarter of participants were projected to have been willing to pay as much as $10,000.

Greater willingness to pay was associated with working with an uncooperative patient at the time of the injury, or where the participants were probably or definitely exposed to HIV or HCV, when the amount rose to £1,270.


This study presents an estimate of the value healthcare workers place on the ability to avoid a sharps related injury. Given that most participants were nurses or trainees, the sums involve are a significant proportion of their annual wage. The costs of anxiety and worry may be intangible, but they are similar in magnitude top the direct costs associated with the management of sharps related injuries.