Objectives: To use Willingness to Pay (WTP), as a determinant of value for samples from healthcare systems in Ireland, (North and South), associated with orthodontic care and compare the factors that influence WTP.

Methods: A longitudinal study supported by HEA North South Research Programme. Convenience sampling was used to recruit 387 consecutive patients aged 11 to 21 years about to commence orthodontic treatment. Patients were recruited from publically funded orthodontic clinics in the North (NPF), and clinics in the South, private (SP), teaching hospital (STH) and publically funded (SPF). Interview-based questionnaires designed by the research team were used to determine, patient and parental factors. Professional assessments were performed on study models by calibrated orthodontists. Open ended contingent valuation interview based questions were used to determine WTP by the parent to obtain straight teeth for their child. 

Results: 363 parents answered WTP questions. Mean WTP (NPF) = 1155 n = 157, (SPF) = 4627.78 n = 27, (SP) = 4300.86 n = 58, (STH) = 2412.40 n = 121. Multivariate regression analysis was used to determine significant factors influencing WTP. Factors included, for NPF = Household income β=11.890, P=0.000, and Perceived need child β (Yes) =0.00 (No)=-1125.62 P=0.010 and for SPF, SP, STH = Household income β=20.474 P=0.000 and aesthetic need (professionally determined by Index of Orthodontic Treatment Need Aesthetic Component (IOTNAC). β(IOTNAC) 3=-796.76(P=0.253),4=-2220.06(P=0.005),5=-1898.69(P=0.010),6=-893.21(P=0.133).7=-1739.83(P=0.244),8=-1205.05(P=0.068),9=-774.45 (P=0.369),10=0.00.

Conclusion: In North parents place a higher value on treatment if their child feels they need braces. In South parental values are determined more by aesthetics, and parents are WTP for professionally assessed low aesthetic need. The amount the parent is WTP in both the North and South rises with household income.