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Payment systems and oral health in Swedish dental care: Observations over six years.

Journal article
Authors Charlotte Andren Andås
Magnus Hakeberg
Published in Community Dental Health
Volume 33
Issue 4
Pages 257-261
ISSN 0265-539X
Publication year 2016
Published at Institute of Odontology
Pages 257-261
Language en
Keywords capitation; dental caries; fee-for-item; oral health; Sweden
Subject categories Public health science


Objective: The aim of this longitudinal study of patients in regular dental care was to compare the findings of manifest caries and fillings after a 6-year adherence to either of two optional payment models, the traditional fee-for service (FFS) model, or the new capitation model 'Dental Care for Health' (DCH). Material and methods: Data on manifest caries lesions, the number of fillings and a number of background variables were collected from both a register and a questionnaire completed by 6,299 regular dental patients who met the inclusion criteria. The influence of payment system adherence and background variables on the number of manifest caries lesions at study end was examined by the means of negative binomial regression analysis. Results: The incidence rate ratio of manifest caries lesions after six years in FFS was 1.5 compared to DCH, after controlling for age, gender, education and pre-baseline caries incidence. The number of fillings was higher in FFS than in DCH at study start and at study end, and was also described by a steeper slope. Conclusions: At group level, this study showed a statistically significant difference between the caries situation after six years in DCH compared with FFS, when some important background factors, including pre-baseline caries, were kept constant in a regression model.

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