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Patient characteristics in relation to dental care payment model: Capitation vs fee for service

Journal article
Authors Magnus Hakeberg
Ulla Wide Boman
Published in Community Dental Health
Volume 33
Issue 4
Pages 252-256
ISSN 0265-539X
Publication year 2016
Published at Institute of Odontology
Pages 252-256
Language en
Keywords Capitation, Epidemiology, Health behavior, Socio-economic status, Sweden
Subject categories Public Health, Global Health, Social Medicine and Epidemiology, Dentistry, Odontological behavioural science


© BASCD 2016.Objective: To analyse patient profiles in two payment models, the capitation (DCH) and the fee-for-service (FFS) systems, in relation to socioeconomic status, self-reported health and health behavior, as well as patient attitudes to and satisfaction with the DCH model in the Public Dental Service (PDS) in Sweden. Research design and participants: The present survey included a random national sample of the adult population in Sweden. A telemarketing company, TNS SIFO, was responsible for the sample selection and telephone interviews conducted in May 2013. The 3,500 adults (aged ≥19 years) included in the sample gave a participation rate of 49.7%. Results: Individuals choosing DCH were younger. FFS patients rated their health as less good, were less physically active, were more often smokers and had a lower household income. The DCH patients were more satisfied with their payment model than the FFS patients (98% vs 85%). A multivariate analysis showed that three of the variables significantly contributed to the model predicting DCH patients: age, with an odds ratio of 0.95, household income (OR=1.85) and importance of oral health for well-being (OR=2.05). Conclusions: There was a pattern of dimensions indicating the choice of payment model among adult patients in the Swedish Public Dental Service. The patients in DCH had higher socioeconomic position, were younger, rated their oral health as better and were more satisfied with the payment model (DCH) than the patients in the FFS system.

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