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Changes in utilization and cost sharing within the Danish National Health Insurance dental program, 1975-90.

https://arctichealth.org/en/permalink/ahliterature62859
Source
Acta Odontol Scand. 1996 Feb;54(1):29-35
Publication Type
Article
Date
Feb-1996
Author
E. Schwarz
Author Affiliation
Department of Periodontology and Public Health, Faculty of Dentistry, University of Hong Kong, Hong Kong.
Source
Acta Odontol Scand. 1996 Feb;54(1):29-35
Date
Feb-1996
Language
English
Publication Type
Article
Keywords
Adult
Cost Sharing
Costs and Cost Analysis
Denmark - epidemiology
Dental Care - economics - statistics & numerical data - utilization
Dental Restoration, Permanent - statistics & numerical data
Diagnosis, Oral - statistics & numerical data
Financing, Organized
Financing, Personal
Health Expenditures
Health Services Needs and Demand - statistics & numerical data
Humans
Insurance, Dental - economics - statistics & numerical data
National Health Programs - economics - statistics & numerical data
Oral Health
Preventive Dentistry - statistics & numerical data
Research Support, Non-U.S. Gov't
Tooth Extraction - statistics & numerical data
Abstract
The aims of the analysis were 1) to examine the development in utilization of dental care provided for adults in Denmark under the National Health Insurance during the period 1975-90; 2) to assess the appropriateness of available dental care statistics for studies of oral health trends; and 3) to analyze the price development of dental services during 1975-90 and its impact on patient and Insurance expenses, respectively. Utilization and economic data were retrieved from available registers and analyzed. Three trends were found. First, the utilization has increased more than what could be explained by the population increase; secondly, the panorama of dental services changed from predominantly restorative/extraction services to predominantly diagnostic/preventive services. Thirdly, the price paid by Danish adults for dental care increased disproportionately to other price developments in society. On the basis of traditional health economic theory this development could be expected to affect demand for dental services negatively.
PubMed ID
8669238 View in PubMed
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Dental care of young adults in west Sweden.

https://arctichealth.org/en/permalink/ahliterature33042
Source
Swed Dent J. 1999;23(4):133-40
Publication Type
Article
Date
1999
Author
O. Sjöström
B. Jälevik
D. Holst
Author Affiliation
Bohus County Council, Göteborg, Sweden.
Source
Swed Dent J. 1999;23(4):133-40
Date
1999
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Comparative Study
Costs and Cost Analysis
Dental Care - economics - statistics & numerical data - utilization
Dental Health Surveys
Female
Humans
Male
Private Practice - economics - statistics & numerical data - utilization
Public Health Dentistry - economics - statistics & numerical data
Random Allocation
Risk factors
Sweden
Abstract
107 Swedish subjects, all 20 years old, were studied for the first three years (1990-1992) after they had left the organised dental care for children and adolescents (which is free of charge for all youth through the age of 19). They were registered in four different risk-grouping systems in order to estimate the amount of their future dental care. Three of the systems used registrations from the Public Dental Service records and in the fourth one a dentist made a subjective estimation. The follow-up used dental insurance claims to study performed treatments, courses of treatments and cost. The risk group system that used subjective estimations appeared to be the one that most accurately predicted the actual dental care consumption. Approximately 70% of the subjects received some kind of dental care during the three years. The distribution was not confined to any particular risk group. Ten per cent had received complete dental care annually. Twenty-five per cent went to a private dentist and 75% continued to go to the Public Dental Service. Those who went to a private dentist received substantially more treatment and the annual cost was a little more than twice as much as in the Public Dental Service.
PubMed ID
10591456 View in PubMed
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Effects of a national economic crisis on dental habits and checkup behaviors - a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature259176
Source
Community Dent Oral Epidemiol. 2014 Apr;42(2):106-12
Publication Type
Article
Date
Apr-2014
Author
Christopher Bruce McClure
Sigurður Rúnar Saemundsson
Source
Community Dent Oral Epidemiol. 2014 Apr;42(2):106-12
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Dental Care - economics - statistics & numerical data - utilization
Dental Devices, Home Care - utilization
Economic Recession - statistics & numerical data
Female
Humans
Iceland - epidemiology
Male
Marital status
Middle Aged
Oral Hygiene - economics - statistics & numerical data
Prospective Studies
Questionnaires
Sex Factors
Socioeconomic Factors
Toothbrushing - statistics & numerical data
Young Adult
Abstract
The effects of economic recessions on dental health behaviors and care utilization are vastly unexamined. Thus, we aimed to ascertain changes in dental health behaviors and checkup frequency from before to after the start of the 2008 Icelandic economic collapse using a nationally representative, prospective cohort - the Health and Wellbeing in Iceland cohort.
Participants in the cohort (n?=?4100) were contacted first from October to December of 2007 and again from November to December of 2009. The questionnaires assessed respondent's demographics, dental behaviors (brushing, flossing), and dental checkup frequency. We present odds ratios derived from multivariate logistic regression of visiting a dentist annually after the collapse compared with before, as well as odds ratios of daily brushing and flossing habits.
Overall, there was no strong evidence for drastic changes in dental health behaviors as from 2007 to 2009. However, employed men (odds ratio 1.29; 95% confidence interval 1.07-1.54) - as well as unemployed women (1.98; 1.00-3.92) - experienced increased odds of visiting a dentist at least annually. Additionally, men were more likely to brush (1.42; 1.05-1.93) and floss daily (1.20; 1.03-1.42) after the collapse compared with before.
Overall, it seems as if the collapse did not have drastic negative effects on dental health behaviors of the population in Iceland. Our findings suggest that men may have opted for healthier dental health behaviors following the national economic collapse in 2008.
PubMed ID
23889473 View in PubMed
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Effects of dental attendance frequency in heavy and low private care-using young adults.

https://arctichealth.org/en/permalink/ahliterature190154
Source
Acta Odontol Scand. 2002 Mar;60(2):87-92
Publication Type
Article
Date
Mar-2002
Author
Anna-Liisa Suominen-Taipale
Eeva Widström
Author Affiliation
The National Research and Development Center for Welfare and Health, Helsinki, Finland. liisa.suominen-taipale@kuopio.fi
Source
Acta Odontol Scand. 2002 Mar;60(2):87-92
Date
Mar-2002
Language
English
Publication Type
Article
Keywords
Adult
Chi-Square Distribution
Cohort Studies
Confidence Intervals
Dental Care - economics - statistics & numerical data - utilization
Dental Restoration, Permanent - statistics & numerical data
Female
Finland
Follow-Up Studies
Health Care Costs
Humans
Logistic Models
Longitudinal Studies
Male
Odds Ratio
Office visits - statistics & numerical data
Periodontal Diseases - therapy
Preventive Dentistry - statistics & numerical data
Private Practice - economics - statistics & numerical data - utilization
Public Health Dentistry - economics - statistics & numerical data
Registries
Reimbursement Mechanisms - economics
Social Security - economics
Statistics as Topic
Statistics, nonparametric
Abstract
In Finland, adults born in 1961 or later were progressively entitled to subsidies for dental care from private practitioners during 1986-90, while at the same time having access to care in the Public Dental Service. The aim of this study was to compare the effects of attendance frequency of private dental care on treatment costs and treatment spectrum for the heaviest and lowest users over a period. Three separate cohorts of recipients of reimbursements were formed, using the Social Insurance Register. The highest and lowest cost groups in 1986, 1990, and 1994 were followed up to 1997. Initially, the mean numbers of visits were 1.2-1.3 and 5.2-5.6 and cost Euro 48 53 and Euro 358-379 among low users and heavy users, respectively, in all cohorts. Among the heavy users (the high-cost category) infrequent attendance was related to higher and frequent attendance to lower mean annual costs of care. Among the low users (the low-cost category the opposite was true. Those who initially belonged to the high-cost category received in 1997 significantly more (P
PubMed ID
12020120 View in PubMed
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Income-related inequality in the use of dental services in Finland.

https://arctichealth.org/en/permalink/ahliterature174749
Source
Appl Health Econ Health Policy. 2004;3(4):251-62
Publication Type
Article
Date
2004
Author
Lien Nguyen
Unto Häkkinen
Author Affiliation
National Research and Development Centre for Welfare and Health, STAKES, Helsinki, Finland. lien.nguyen@stakes.fi
Source
Appl Health Econ Health Policy. 2004;3(4):251-62
Date
2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Dental Care - economics - statistics & numerical data - utilization
Female
Finland
Health Care Surveys
Healthcare Disparities - economics - statistics & numerical data
Humans
Income - statistics & numerical data
Male
Middle Aged
Models, Econometric
Socioeconomic Factors
Young Adult
Abstract
The aim of this article is to measure and explain income-related inequalities in dentist utilisation. We apply concentration and horizontal inequity indices and the decomposition method to decompose observed inequalities into sources. The data are from the Finnish Health Care Survey of 1996. We examine three measures of utilisation: (a) the total number of visits; (b) the probability of visiting a dentist; and (c) the conditional number of positive visits for (i) visits to all dentists, (ii) those to public dentists and (iii) those to private dentists. The results for the whole sample show pro-poor inequities in all three measures of utilisation in public care, whereas in the first two measures there are pro-rich inequities nationwide and in private care. Among those entitled to age-based subsidised dental care, we find equality and equity in all three measures of utilisation nationwide. The two main factors related to pro-rich distributions of use are income and dentist's recall. To enhance equity in dental care across income groups, attention should be focused on supply factors and other incentives to encourage the poor to contact dentists more often.
PubMed ID
15901199 View in PubMed
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A longitudinal study of young Finnish adults' use of subsidized, private sector dental care, 1986-1997.

https://arctichealth.org/en/permalink/ahliterature197064
Source
Community Dent Oral Epidemiol. 2000 Oct;28(5):365-72
Publication Type
Article
Date
Oct-2000
Author
A L Suominen-Taipale
E. Widström
Author Affiliation
The National Research and Development Centre for Welfare and Health, Helsinki, Finland. liisa.suominen-taipale@medisin-ntnu.no
Source
Community Dent Oral Epidemiol. 2000 Oct;28(5):365-72
Date
Oct-2000
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Chi-Square Distribution
Cohort Studies
Dental Care - economics - statistics & numerical data - utilization
Female
Finland
Health Care Costs
Health Transition
Humans
Insurance, Dental
Insurance, Health, Reimbursement - utilization
Least-Squares Analysis
Logistic Models
Male
Odds Ratio
Private Sector - economics - statistics & numerical data - utilization
Abstract
Finns born after 1956 are now entitled to subsidized private sector dental care, or such persons could be enrolled in the Public Dental Service. Until 1986, eligibility was more restrictive. The purpose of this study was to investigate the use and costs of private dental care and effects of regularity of care on costs and treatment received among young Finnish adults during 1986-1997.
All 1986, 1990 and 1994 recipients of reimbursement for dental care from the Social Insurance Institution were included in the study. Five separate age cohorts were compared. Using their civil registration numbers, individuals were tracked from their first contact with a private dentist in one of the years 1986, 1990 or 1994 until the year 1997.
While the total number of young adults who had received reimbursement for private dental care increased from about 53000 (1986) to 200000 (1994) due to extended eligibility, the number of users in the youngest group decreased from 53000 to 23000. Attending infrequently (1-2 times during the study period) was most common among the youngest adults and frequent attendance (annually) was most common among older adults. The annual mean cost was slightly lower among the frequent attenders in almost every cohort. Variation in the mean number of annual visits was directly correlated with costs. Frequent attenders most often received diagnostic and preventive measures while restorations and surgery were most common for the infrequent attenders.
A substantial decline in the demand for private services among the 19-25-year-olds and stable demand among 26-34-year-olds was detected, indicating falling treatment needs or a preference for the Public Dental Service. All groups had a stable mean number of visits per year and almost constant costs. The mean number of dental visits per year remained steady in all cohorts indicating rigid treatment patterns.
PubMed ID
11014513 View in PubMed
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Prosthodontics, care utilization and oral health-related quality of life.

https://arctichealth.org/en/permalink/ahliterature77442
Source
Swed Dent J Suppl. 2007;(185):7-81
Publication Type
Article
Date
2007
Author
Bagewitz Ingrid Collin
Author Affiliation
Malmö högskola, 2007 Department of Prosthetic Dentistry, Faculty of Odontology.
Source
Swed Dent J Suppl. 2007;(185):7-81
Date
2007
Language
English
Publication Type
Article
Keywords
Aged
Attitude to Health
Dental Care - economics - statistics & numerical data - utilization
Dental Prosthesis - economics - methods - psychology
Dentures - economics - methods - psychology
Female
Humans
Insurance, Dental - economics
Male
Middle Aged
Oral Health - standards
Quality of Life
Questionnaires
Socioeconomic Factors
Sweden
Tooth Loss - economics - psychology
Abstract
The main aim of this thesis was to study the impact of oral health and oral prostheses on oral health-related quality of life (OHRQOL) in an adult Swedish population. Additional aims were to study social inequalities in oral health, attitudes towards the cost for dental care and dental care utilization. The study base was 1294 responses to a questionnaire from a random sample of 1974 persons aged 50-75 years, all of whom were resident in the County of Skine, Sweden. There was an association between impaired dental conditions and poor social conditions. Low dental care utilization covaried with impaired dental conditions and with stating a perceived need to obtain dental care but with no possibility to obtain it because of a cost barrier. In factor analysis, three factors captured 22 variables that aimed to measure OHRQOL. The constituent variables were summed into three index variables interpreted as oral health impact on everyday activities, on a psychological dimension and on oral function. The three variables were set as dependent variables in regression models with the independent variables social attributes, individual attributes, dentures, number of teeth and dental care attitudes. The models were run in three steps taking into account the interaction between the type of denture and the number of remaining teeth. The number of remaining teeth was more important than the type of denture when explaining OHRQOL. The type of replacement, in terms of fixed or removable denture, was less important for those with few or no remaining teeth, than for all others. OHRQOL was also explained by general health in relation to age peers as well as by varying attitudes towards dental care costs. Statistically significant interactions were observed between the number of remaining teeth and the type of denture when explaining OHRQOL. As a whole the thesis shows that social and dental conditions and cost for dental care play a great role for dental care utilization as well as for OHRQOL. Prosthodontics has an important role, where type of replacement interacts with tooth loss in its effect on QOL.
PubMed ID
17566316 View in PubMed
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Utilization of dental health services among middle-aged people in Sweden and Denmark.

https://arctichealth.org/en/permalink/ahliterature52217
Source
Acta Odontol Scand. 2002 Oct;60(5):276-80
Publication Type
Article
Date
Oct-2002
Author
Mats Kronström
Sigvard Palmqvist
Björn Söderfeldt
Merete Vigild
Author Affiliation
Department of Prosthetic Dentistry, Faculty of Odontology, Malmö University, Sweden. mats.kronstrom@vgregion.se
Source
Acta Odontol Scand. 2002 Oct;60(5):276-80
Date
Oct-2002
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Chi-Square Distribution
Comparative Study
Denmark
Dental Care - economics - statistics & numerical data - utilization
Dental Health Services - economics - statistics & numerical data - utilization
Female
Financing, Personal - statistics & numerical data
Humans
Income
Insurance, Dental
Logistic Models
Male
Middle Aged
Models, Theoretical
Multivariate Analysis
Office visits - statistics & numerical data
Oral Health
Probability
Questionnaires
Sex Factors
Sweden
Abstract
In 1999, questionnaires were sent to random samples of 1001 Swedish citizens aged 55-79 years and 1175 Danish citizens aged 45-69 years. Various questions were asked concerning dental conditions, dental visit frequency per year, and money spent annually on dental care, etc. The objectives were to assess differences in the utilization of dental services and to compare out-of-pocket costs for dental care in Sweden and Denmark with control for age, gender, dental conditions and income. More than 80% of the subjects reported that a dentist had examined them less than 1 year previously. However, 77% of the Danes reported dental visits twice a year or more compared to 28% of the Swedes. Although the Danes reported a more frequent use of dental services, they had poorer dental conditions compared to the Swedes. Even though the Swedes used dental services less often than the Danes did, more subjects reported high 12-month out-of-pocket costs. In the present study, separate models were constructed for the two countries because there could be different mechanisms at play, as indicated by the results. The different insurance systems along with different degrees of commercialization in the two countries might be the most decisive factors in this context.
PubMed ID
12418717 View in PubMed
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8 records – page 1 of 1.