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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dc.contributor.author Johansson, Veronica
dc.contributor.author Axtelius, Björn
dc.contributor.author Söderfeldt, Björn
dc.date.accessioned 2009-12-15T15:46:24Z
dc.date.available 2009-12-15T15:46:24Z
dc.date.issued 2009
dc.identifier.uri http://hdl.handle.net/2043/9098
dc.description.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. en
dc.language.iso eng en
dc.subject.classification Medicine en
dc.title A path analysis of contract and fee-for-service care en
dc.type Conference Poster en
dc.relation.url http://www.eadph2009.no/
dc.contributor.department Malmö University. Faculty of Odontology
dc.description.other 14th Annual Congress of the European Association of Dental Public Health (EADPH), Tromsö, Norway, September 3-5 2009. en
dc.subject.srsc Research Subject Categories::ODONTOLOGY en
dcterms.description.conferenceName Congress of the European Association of Dental Public Health (EADPH)
dcterms.description.conferencePlace Tromsö, Norway
dcterms.description.conferenceYear 2009
mahlocal.rights.oaType green
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