Remuneration of dental care - how to give patients and dentists what they need

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Remuneration of dental care - how to give patients and dentists what they need

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Publication Conference Paper, other
Title Remuneration of dental care - how to give patients and dentists what they need
Author Söderfeldt, Björn
Date 2007
Swedish abstract
There are at least three different systems in remuneration of dental care: Fee-for-service (FFS), capitation (CAP), and national health service (NHS). Empirically, FFS dominates, with elements of CAP and NHS in some countries. Advantages and disadvantages with all the systems are reviewed. In moral philosophy, there are also three different ways to distribute something good - according to Right, Desert, and Need. The matrix of these distributory principles and the remuneration systems is presented and analysed, with attention to the need concept. Right is connected to CAP, Desert to FFS, and Need to NHS. There is scarce empirical evidence relevant for this model. In the few studies done, CAP decreases restorative treatment and there is a tendency of decreased caries incidence. “Supervised neglect” cannot be established. CAP increases preventive care. Results regarding productivity are inconclusive. One study points to improved patient Oral Health-Related Quality of Life with CAP in comparison to FFS. The results on dentist´s satisfaction with work were inconclusive, as were the results regarding patient satisfaction. There are no studies evaluating need in relation to remuneration system. In conclusion, there is no empirical evidence for choice of remuneration system. whence theoretical argument is the only available. Relieving dentistry from monetary concerns in the clinical decision-making should then be desirable, pointing to some form of NHS as preferred system.
Language swe (iso)
Subject Medicine
ODONTOLOGY
Note Pre-Congress EADPH 2007, Gent, Belgium
Handle http://hdl.handle.net/2043/5397 Permalink to this page
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