A path analysis of contract and fee-for-service care

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A path analysis of contract and fee-for-service care

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Publication Conference Poster
Title A path analysis of contract and fee-for-service care
Author(s) Johansson, Veronica ; Axtelius, Björn ; Söderfeldt, Björn
Date 2009
English abstract
Objectives: In Swedish dentistry, the traditional patient financial system is fee-for-service care (FFS). Since 1999, the public dental health service (PDHS) in the county of Värmland offers an alternative system, contract care (CC). Here, the patient pays a set fee for a fixed period of time, and receives oral health care as specified by a contract, without additional costs. Previously, an association between patient financial system and oral health-related quality of life (OHRQoL) was found. The aim was to model direct and indirect effects with path analysis, to study if there were different underlying mechanisms in the patient financial systems. Material and methods: In 2003, a questionnaire was sent to randomly selected patients enrolled in CC (n=1,200) and FFS (n=1,200) in the PDHS in Värmland. The study was approved by the ethical board in the Southern region of Sweden. Response rate was 57%. Data without internal non-response (n=1,044; CC: 57%, FFS: 43%) were analysed with a multiple group path analysis. The interactions of four variables were of central interest: OHRQoL, the respondents’ perceptions of the dental caregiver’s humanistic (patient-, as opposed to disease-centred) qualities, what the respondents were prepared to pay, and what they had paid for dental care the previous year. Results: The underlying mechanisms in the systems were similar. However, there were differences regarding the central variables: the perceived humanism of the caregiver affected OHRQoL only in FFS, while what the respondents were prepared to pay for dental care was affecting the perception of humanism only in CC. Conclusions: The findings indicated that the perception of the caregiver’s humanistic qualities were important for oral health for respondents in FFS, while financial considerations were important for how the caregiver’s qualities were perceived by respondents in CC. Funding: The study was financed by the Swedish Research Council.
Language eng (iso)
Subject(s) Medicine
Research Subject Categories::ODONTOLOGY
Note 14th Annual Congress of the European Association of Dental Public Health (EADPH), Tromsö, Norway, September 3-5 2009.
Handle http://hdl.handle.net/2043/9098 (link to this page)
Link http://www.eadph2009.no/ (external link to related web page)

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