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Provider payment bares teeth: Dentist reimbursement and the use of check-up examinations

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  • Listl, Stefan
  • Chalkley, Martin

Abstract

Oral diseases are one of the most common diseases globally, yet maximizing health benefits from available resources continues to be a pivotal challenge. Similar to recall appointments in many other medical settings, dental check-up examinations are an essential element of regular treatment. Check-ups are important for ensuring good health but their frequent consumption also implies substantial aggregate health care costs. Although it is crucial to determine appropriate utilization amounts, little is known about the role of financial incentives for both patient and provider. Our analyses relied on ten-year administrative panel data from the Scottish National Health Service including about 1.3 million dental treatment claims which were issued between January 1998 and September 2007. Controlling for unobserved heterogeneity, we estimated a series of fixed-effects models to identify the impact of changes in provider payment and patients' cost sharing on check-up utilization. A significantly higher utilization of examinations was observed if dentists were paid fee-for service compared with salary. Comparably little variation in check-up use was attributable to different extents of patient co-payment. These findings establish that different provider payment methods have a substantial impact on check-up utilization. Because recall appointments in many other medical settings have similar features as dental check-ups, these findings may be relevant for health care decision makers who seek to optimize incentive schemes for all kinds of health care.

Suggested Citation

  • Listl, Stefan & Chalkley, Martin, 2014. "Provider payment bares teeth: Dentist reimbursement and the use of check-up examinations," Social Science & Medicine, Elsevier, vol. 111(C), pages 110-116.
  • Handle: RePEc:eee:socmed:v:111:y:2014:i:c:p:110-116
    DOI: 10.1016/j.socscimed.2014.04.020
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    References listed on IDEAS

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    1. Birch, Stephen, 1988. "The identification of supplier-inducement in a fixed price system of health care provision : The case of dentistry in the United Kingdom," Journal of Health Economics, Elsevier, vol. 7(2), pages 129-150, June.
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    Cited by:

    1. Olivier Kalmus & Martin Chalkley & Stefan Listl, 2022. "Effects of provider incentives on dental X-raying in NHS Scotland: what happens if patients switch providers?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 59-65, February.
    2. Frank Gabel & Olivier Kalmus & Kasper Rosing & Anna‐Lena Trescher & Stefan Listl, 2020. "Implementation of altered provider incentives for a more individual‐risk‐based assignment of dental recall intervals: evidence from a health systems reform in Denmark," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 475-488, April.
    3. Nolan, Anne, 2019. "Reforming the delivery of public dental services in Ireland: potential cost implications," Research Series, Economic and Social Research Institute (ESRI), number RS80, June.
    4. Naasegnibe Kuunibe & Julia Lohmann & Michael Schleicher & Jean‐Louis Koulidiati & Paul Jacob Robyn & Zambendé Zigani & Adama Sanon & Manuela De Allegri, 2019. "Factors associated with misreporting in performance‐based financing in Burkina Faso: Implications for risk‐based verification," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1217-1237, October.
    5. Ake Blomqvist & Frances Woolley, 2018. "Filling the Cavities: Improving the Efficiency and Equity of Canada’s Dental Care System," C.D. Howe Institute Commentary, C.D. Howe Institute, issue 510, May.
    6. Martin Chalkley & Stefan Listl, 2017. "First do no harm – The impact of financial incentives on dental x-rays," Working Papers 143cherp, Centre for Health Economics, University of York.
    7. Chalkley, Martin & Listl, Stefan, 2018. "First do no harm – The impact of financial incentives on dental X-rays," Journal of Health Economics, Elsevier, vol. 58(C), pages 1-9.

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