March 2007

Volume 24, Issue 1

Financial systems’ impact on dental care; a review of fee-forservice and capitation systems

Authors: K. Sondell M. Lannerud F. Sampogna B. Söderfeldt B. Axtelius V. Johansson


Objective This review covers the impact of financial systems on dental care. Background Remuneration in fee-for-service (FFS) is done per service provided and in capitation (CAP) per patient enrolled. It may be expected that dentists’ incentive in CAP is to keep the number of services provided at a minimum, while in FFS it is to keep the number of services at a maximum. This should lead to a different impact on care, with the dentists in CAP focusing more on prevention and dentists in FFS more on restorative treatment. Six questions were put: Does CAP increase or decrease caries incidence? Does CAP increase or decrease restorative treatments? Does CAP increase preventive care? Does CAP increase or decrease productivity? Does CAP increase or decrease the dentist’s satisfaction with his/her work? Does CAP increase or decrease the patients’ satisfaction with the oral care provided? Methods Literature was obtained through searches in databases. A format was developed to define the literature of interest. Results CAP decreases restorative treatment and there is a tendency of decreased caries incidence. “Supervised neglect” cannot be established. CAP increases preventive care. A conclusion regarding productivity was not possible. The results on dentist’s satisfaction with work were inconclusive, as were the results regarding patient satisfaction. Conclusions CAP has a different impact on provided care than FFS. More research is needed in this area and focus on efficiency is of importance. This review was funded by the Swedish Research Council. Key words: Capitation, caries incidence, preventive treatment, productivity, restorative treatment, satisfaction


Other articles in this issue

Article Pages Access
Editorial - Expanding dental undergraduate clinical outreach programmes into general dental practice. 2-3 Download
Community effectiveness of fissure sealants and the effect of fluoridated water consumption 4-11 Download
Financial systems’ impact on dental care; a review of fee-forservice and capitation systems 12-20 Download
Agreement amongst examiners assessing dental fluorosis from digital photographs using the TF index. 21-25 Download
Frequency and distribution patterns of sealants among 15-year-olds in Denmark in 2003 26-30 Download
Enamel defects and its relation to life course events in primary dentition of Brazilian children: A longitudinal study 31-36 Download
Oral health care and status of elderly care home residents in Glasgow. 37-42 Download
Knowledge of and attitudes toward severe acute respiratory syndrome among a cohort of dental patients in Hong Kong following a major local outbreak 43-48 Download
Conversion tables for the Corah and Modified Dental Anxiety Scales 49-54 Download
An audit of paediatric dental treatments carried out under general anaesthesia in a sample of Spanish patients 55-58 Download
BASCD Survey - The dental caries experience of 5-year-old children in Great Britain (2005/6). Surveys co-ordinated by the British Association for the Study of Community Dentistry. 59-63 Download


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