The relationship between practice ownership and follow-up of comprehensive dental care. A Swedish register study

Authors

  • Bengt Franzon Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden https://orcid.org/0000-0002-5668-9519
  • Mikael Moutakis Department of Economics, Gothenburg University, Gothenburg, Sweden; The Swedish Dental- and Pharmaceutical Benefits Agency, Stockholm, Sweden
  • Björn Axtelius Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden
  • Sigvard Åkerman Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
  • Björn Klinge Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden https://orcid.org/0000-0003-2100-2446

DOI:

https://doi.org/10.2340/aos.v83.40277

Keywords:

Ownership, private practice, socioeconomic factors

Abstract

Aims: The aims of this register study were:

1. 
To study whether the type of ownership of the dental practice was correlated with the type of dental care provided, that is public versus private ownership and professional (dentist or dental hygienist) versus non-professional ownership.

2. 
To study the extent of follow-up of patients who have undergone two types of treatments. 

Material and method: Two types of dental care were defined in the two groups studied, periodontitis/peri-implantitis and comprehensive restorative/rehabilitation. All relevant treatment codes that fall under these definitions are noted when they are performed. Also, the follow-up of each treatment code is noted. Differences in dental and socioeconomic status over time and between regions were adjusted for. A drop-out analysis was performed. 

Results: Dental practices owned by dentists or dental hygienists schedule follow-up appointments for patients who have undergone comprehensive restorative or rehabilitation dentistry more often than practices with other types of ownership. Dental practices owned by dentists or dental hygienists follow up patients with periodontitis and peri-implantitis less frequently.

Conclusion: Type of ownership of a dental business influences the extent to which periodontal, and comprehensive restorative or rehabilitation dentistry were followed up.

Downloads

Download data is not yet available.

References

Finansdepartementet Dir. 2015:22. Ett nytt regelverk för offentlig finansiering av privat utförda välfärdstjänster. [Government Committee Directive]. A new regulatory framework for public funding of privately performed welfare services] [Internet]. Swedish [cited 23-09-2023]. Available from: https://www.regeringen.se/contentassets/7d26d17bdd394a1c934185a445315780/ett-nytt-regelverk-for-offentlig-finansiering-av-privat-utforda-valfardstjanster-dir.-201522

Franzon B, Axtelius B, Åkerman S, et al. Dental politics and subsidy systems for adults in Sweden from 1974 until 2016. BDJ Open. 2017;3:17007. https://doi.org/10.1038/bdjopen.2017.7

Lindblom C. I väntan på tandvård: Hur tandrötan blev politik [In anticipation of dentistry: How tooth decay became politic]. Dissertation. Stockholm: Carlssons Bokförlag; 2004. Swedish.

Privattandläkarnas branchrapport 2020. [The association for private dental care providers in Sweden industry report 2020] [Internet]. Swedish. [cited 28-09-2023]. Available from: https://ptl.se/wp-content/uploads/2021/02/Rapport_branschrapport_2020.pdf

Socialstyrelsen Tandhälsoregistret. [The National Board of Health and Welfare’s dental health register] [Internet]. Swedish [cited 15-09-2023]. Available from: https://www.socialstyrelsen.se/statistik-och-data/register/tandhalsoregistret/

SOU 2021:8. [Swedish Government Official Reports 2021:8]. När behovet får styra- ett tandvårdssystem för mer jämlik tandhälsa [When the need arises – a dental care system for more equal dental health] [Internet]. [cited 23-09-2023]. Swedish. Available from: https://www.regeringen.se/rattsliga-dokument/statens-offentliga-utredningar/2021/03/sou-20218/

Widström E, Augustdottir H, Byrkjeflot L, et al. Systems for provision of oral health care in the Nordic countries [Internet]. [cited 29-09-2023]. Available from: https://www.tandlaegebladet.dk/sites/default/files/articles-pdf/TB092015-702-711.pdf

Sinclair E, Eaton KA, Widström E. The healthcare systems and provision of oral healthcare in European Union member states. Part 10: comparison of systems and with the United Kingdom. Br Dent J. 2019;227(4):305–10. https://doi.org/10.1038/s41415-019-0661-4

Corporate Dentistry in Europe CED Resolution, CED-DOC-2019-045-FIN-E. [cited 10-01-2019 ]Available from: https://www.omd.pt/content/uploads/2019/01/ced-corporate-dentistry-en-2018.pdf

Praktikertjänst tandvård [Internet]. [cited 29-09-2023]. Swedish. Available from: https://www.praktikertjanst.se/tandvard/

Peres MA, Macpherson LMD, Weyant RJ, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249–60. https://doi.org/10.1016/S0140-6736(19)31146-8. Erratum in: Lancet. 2019 Sep 21;394(10203):1010. PMID: 31327369.

Watt RG, Daly B, Allison P, et al. Ending the neglect of global oral health: time for radical action. Lancet. 2019;394(10194):261–72. https://doi.org/10.1016/S0140-6736(19)31133-X

Otto M. Teeth: the story of beauty, inequality, and the struggle for oral health in America. New York: New Press; 2016.

WHO health topics oral health. [cited 14-06-2021]. Available from: https://www.who.int/health-topics/oral-health/#tab=tab_1

Hugoson A, Koch G, Johansson S. Konsensuskonferens oral hälsa. [Consensus conference Oral Health]. Jönköping: Förlagshuset Gothia; 2003. Swedish.

Socialstyrelsen. [The National Board of Health and Welfare] [Internet]. [cited 23-09-2023]. Swedish. Available from: https://www.socialstyrelsen.se/kunskapsstod-och-regler/regler-och-riktlinjer/nationella-riktlinjer/riktlinjer-och-utvarderingar/tandvard/

Sandberg H, Fors U. Den nivågrupperade modellen – riskgruppering för bättre tandhälsa. [The level-grouped model – risk grouping for better dental health]. Swed Dent J. 2007;31:171–179. Swedish.

Ljung R, Lundgren F, Appelquist M, et al. The Swedish dental health register – validation study of remaining and intact teeth. BMC Oral Health. 2019;19(1):116. https://doi.org/10.1186/s12903-019-0804-7

TLV [The Dental and Pharmaceutical Benefits Agency] [Internet]. [cited 29-09-2023]. Available from: https://www.tlv.se/tandvard/regelverk-om-tandvardsstodet.html. Swedish.

SCB. Longitudinell integrationsdatabas för sjukförsäkrings-och arbetsmarknadsstudier (LISA) [Statistics Sweden. Base of longitudinal integration dates for health and labor market health insurance (LISA)] [Internet]. [cited 29-09-2023]. Swedish. Available from: https://www.scb.se/LISA.

SCB. Disponibel inkomst per konsumtionsenhet för hushåll 20-64 år efter hushållstyp 2019]. [Statistics Sweden. Disposable income per consumption unit for households 20–64 years by household type 2019] [Internet]. [cited 29-09-2023]. Swedish. Available from: https://www.scb.se/hitta-statistik/temaomraden/jamstalldhet/ekonomisk-jamstalldhet/inkomster-och-loner/.

Greene WH. Incidental truncation and sample selection. Econometric analysis. 7th ed. Boston, MA: Pearson; 2012.

Leeper TJ. Interpreting regression results using average marginal effects with R´s margins. [cited 12-12-2023]. Available from: https://cran.hafro.is/web/packages/margins/vignettes/TechnicalDetails.pdf

McFadden D. Regression-based specification tests for the multinomial logit model. J Econometr. 1987;34(1–2):63–82. https://doi.org/10.1016/0304-4076(87)90067-4

McFadden D. Conditional logit analysis of qualitative choice behavior. Frontiers in econometrics. New York, NY: Academic Press; 1974, pp. 105–142.

Löfgren A. Recognition of temporomandibular disorders: validity and outcome of three screening questions. Dissertation. Umeå: Umeå University, Odontological dissertations; 2017, p. 137.

Wöstmann B, Budtz-Jørgensen E, Jepson N, et al. Indications for removable partial dentures: a literature review. Int J Prosthodont. 2005;18(2):139–45.

SOU 2007:19 Friskare tänder till rimliga kostnader [Swedish Government Official Reports: Healthier teeth – at a reasonable cost] [Internet]. [cited 12-12-2023]. Swedish. Available from: https://www.regeringen.se/rattsliga-dokument/statens-offentliga-utredningar/2007/03/sou-200719/.

Cheng TC, Haisken-DeNew JP, Yong J. Cream skimming and hospital transfers in a mixed public-private system. Soc Sci Med. 2015;132:156–64. https://doi.org/10.1016/j.socscimed.2015.03.035

The social democratic labor party in Sweden [Internet]. [cited 29-09-2023]. Swedish. Available from: https://www.socialdemokraterna.se/var-politik/a-till-o/vinster-i-valfarden.

Sievers J. Hon vill se smarta flöden. [She wants to see smart flows] [Internet]. Tandläkartidningen [Internet]. 2019 [cited 23-09-2023];7:28–32. Swedish. Available from: https://www.tandlakartidningen.se/nyhet/hon-vill-se-smarta-floden/

SKAPA, Svenskt kvalitetsregister för karies och parodontit. Årsrapport 2019. [Swedish Quality Register for Caries and Periodontitis. Annual report 2019]. [cited 2023-09-29]. Swedish.

Genco RJ, Sanz M. Clinical and public health implications of periodontal and systemic diseases: an overview. Periodontol 2000. 2020;83(1):7–13. https://doi.org/10.1111/prd.12344

Holmstrup P, Damgaard C, Olsen I, et al. Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician. J Oral Microbiol. 2017;9(1):1332710. https://doi.org/10.1080/20002297.2017.1332710

Folkhälsomyndigheten [Public Health Agency of Sweden] [Internet]. [cited 04-09-2023]. Swedish. Available from: https://www.folkhalsomyndigheten.se/publikationer-och-material/publikationsarkiv/j/jamlik-tandhalsa/?pub=59629.

Published

2024-04-16