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Per capita remuneration of dentists and the quality of dental services.
MedLine Citation:
PMID:  23330690     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to examine the effects of a per capita based remuneration system on the quality of dental care. METHODS: The basis for the study was a natural experiment in the county of Østfold in Norway in which all public dental officers (n = 34) were given the opportunity to renegotiate their contract from a fixed salary to a combined per capita and fixed salary contract. Quality was assessed according to three criteria: number of preventive procedures, number of under-diagnosed carious lesions and number of untreated carious lesions. This information was selected from a random sample of patient records for 18-year-olds in the autumn of 1999 (base-line data) and at the end of 2006 (final data), altogether 20 records per dentist. At the end of the period of evaluation, 26 dentists were still eligible for inclusion in the study. The data were analysed both descriptively and using multilevel difference-in-difference regression models. RESULTS: The main finding was that the transition to a per capita remuneration system did not lead to under-diagnosis of carious lesions, under-treatment or less prevention. CONCLUSIONS: A per capita remuneration scheme did not lead to a fall in the quality of dental care. This result must be assessed taking into account that the experiment was carried out within a publicly financed and managed dental service. Also, the incentive effect of the per capita contract was relatively weak.
Authors:
Jostein Grytten; Dorthe Holst; Irene Skau
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-21
Journal Detail:
Title:  Community dentistry and oral epidemiology     Volume:  -     ISSN:  1600-0528     ISO Abbreviation:  Community Dent Oral Epidemiol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0410263     Medline TA:  Community Dent Oral Epidemiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.
Affiliation:
Department of Community Dentistry, University of Oslo, Oslo, Norway.
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