| 1. |
- Andås, Charlotte Andren, et al.
(författare)
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A new dental insurance scheme - effects on the treatment provided and costs
- 2014
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 38:2, s. 57-66
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate whether the revenues cover the costs in a pilot capitation plan, a dental insurance scheme, and to compare this capitation plan (CP) with the original fee-for-service system (FFS), in terms of the amount and type of dental care provided. Data was collected longitudinally over a period of three years from 1,650 CP patients in five risk groups at a test clinic, and from 1,609 (from the test clinic) and 3,434 (from a matched control clinic) FFS patients, in Goteborg, Sweden. The care investigated was the number of total treatments provided and the number of examinations by dentists and dental hygienists, together with preventive, restorative and emergency treatments. The economic outcome was positive from the administrator's perspective, in all risk groups for the three-year period. The amount and type of care provided differed between the payment models, as CP patients received more preventive treatments, less restorative treatments, and more examinations by dental hygienists than the FFS patients. Emergency treatment was performed more often on CP patients, and the difference was due to a higher frequency of such treatments among women in the CP group. The difference between clinics concerning certain treatment measures was sometimes greater than the difference between payment models. The results from this study indicate a net positive economic outcome for the pilot CP system over three years. The payment model and the clinic affiliation had impact on what type and amount of dental care the patients received. This might suggest that the risk of skewed selection and its consequences as well as the influence of clinic-specific practice need further investigation, to ensure economic sustainability in a longer perspective.
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| 2. |
- Bergholm, Å, et al.
(författare)
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Implementation of laser technology and treatment at county level in the Swedish Public Dental Service
- 2014
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 38:3, s. 111-120
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to obtain an understanding of the factors that affected the way new technology and methods were used in dentistry after a training program. A qualitative research method was used to collect data. Nine dentists working in the Public Dental Service (PDS) in Uppsala County in Sweden agreed to be interviewed in the study. They worked in five different clinics, all with laser equipment, and had received training in the use of lasers.The interviews were tape recorded and transcribed, and were analysed using manifest and latent qualitative content analysis. The categories in this study were identified as "Prerequisites and obstacles to implementation", "Attitudes to laser technology and treatments" and "Laser technology in the future". The dentists described working with lasers as complicated and problematic. They had concerns about the method relating to the working environment, evidence of efficacy of treatment, costs, and benefits for patients and dentists. The main finding was that the decision to adopt the technology seemed to be based on individual perceptions of the value of lasers compared to other ways of achieving the same goal.They provided uniform proposals regarding how an organization should implement new methods, including an emphasis on the importance of preparation and having opportunities to be able to test and evaluate the technology. Another important factor was support from surrounding staff, colleagues and management. Despite all the barriers, the respondents were positive about working with lasers in the future, mainly due to their belief that patients would demand laser treatment. In conclusion both individual and organizational factors affected the extent to which the respondents used the laser.The main finding was the individual perception of the value of lasers compared to other methods which could achieve the same goal.
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| 3. |
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| 4. |
- Ericsson, Jessica S, 1971, et al.
(författare)
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Periodontal health status in Swedish adolescents: an epidemiological, cross-sectional study
- 2009
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 33:(3), s. 131-139
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this epidemiological survey was to analyze the periodontal conditions of 19-year old individuals in two rural county areas, i.e. Fyrbodal and Skaraborg, Västra Götaland, Sweden, with special reference to gender and socioeconomic grouping. A randomized sample of 506 individuals (Fyrbodal 250 and Skaraborg 256 individuals, respectively) was clinically examined with regard to oral hygiene, gingivitis, periodontal pockets and gingival recession. Bitewing radiographs were used for assessment of alveolar bone level (ABL) and dental calculus. A questionnaire-based interview regarding oral hygiene habits was included. A majority of the subjects (76%) claimed to brush their teeth at least twice a day, while interdental hygiene means were used daily by 4%. The subjects showed a mean plaque score of 47% and a gingivitis score of 56%. Forty-six % of the adolescents had a plaque score of > or = 50%, whereas the corresponding figure for gingivitis was 62%. The subjects had on average 5.5 teeth with facial gingival recession. The mean prevalence of sites with probing depth (PPD) of > or = 4 mm was 8, out of which 99% were located at proximal sites. A radiographic bone level of > 2 mm was observed at on average 0.4 teeth per subject. Logistic regression analyses revealed that gender (males) and county area (Fyrbodal) were significant factors for a high plaque and gingivitis score. There was no significant difference in periodontal conditions in relation to socio-economic grouping. In conclusion, the survey revealed higher prevalence of plaque and gingivitis among male than female adolescents, but no differences between socioeconomic groups.
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| 5. |
- Östberg, Anna-Lena, et al.
(författare)
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Cross-cultural adaptation and validation of the Oral Impacts on Daily Performances OIDP) in Swedish
- 2008
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 32:4, s. 187-195
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim was to assess the validity and reliability of a Swedish version of the Oral impacts on Daily Performance (OIDP) index measuring oral health-related quality of life. MATERIAL AND METHODS: After translation and cultural adaptation, a 3-site sample of 204 adults (20-86 years) was interviewed using the OIDP. Moreover, the study included a self-administered questionnaire and a clinical examination. RESULTS: A total of 39.7% reported at least one oral impact on daily life. The most common performances affected were eating and cleaning teeth (both 20.6%). Oral effects on psychological performances caused the highest impacts. No gender or age differences were demonstrated with respect to having at least one impact. However, among those affected, women, old and young subjects scored higher than men and other ages, respectively, on the OIDP. The face and content validity were deemed good in pilot interviews with laypersons and dental professionals. The construct validity was confirmed, as the OIDP score was consistently associated with self-perceived oral health OR 2.13 (95% CI 1.10-4.10) and other self-rated variables, e.g. satisfaction with oral health OR 2.43 (CI 1.34-4.41), also when accounting for age, gender and socioeconomic differences. Associations were estimated using logistic regression. Lacking 10 or more teeth was associated with a higher OIDP score, which supports the criterion validity of the instrument. In a test-retest analysis Cohen's kappa was 0.77. CONCLUSIONS: The Swedish version of the OIDP appears to be a valid and reliable measure for assessing oral impacts on daily performances.
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| 6. |
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| 7. |
- Östberg, Anna-Lena, et al.
(författare)
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Patients' choice of payment system in the Swedish Public Dental Service: views on dental care and oral health
- 2013
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 37:3, s. 131-42
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to generate new knowledge of considerations and factors having impacted the patients’ choice of payment system and their views on oral health. Moreover, their later attitudes to the prepaid risk-related payment system, having been enrolled or not, were explored. A qualitative design was chosen and data was collected through semi-structured interviews. Twenty patients in the Public Dental Service (PDS) in western Sweden were strategically sampled with reference to gender, age (older/younger adults), residence (rural/urban), and choice of payment system: fee-for-service or capitation plan. The interview guide covered areas concerning the payment systems, patient considerations before choosing system, views of their own oral health and experiences of received dental care within the chosen system. The analysis was performed according to basic principles of qualitative content analysis. The results revealed two themes expressing the latent content. In the theme “The individual’s relation to the PDS”, expectations of the care, feelings of safety and aspects of responsibility emerged. The theme “Health-related attitudes and perceptions” revealed that views on health and self-assessment of oral health influenced the patients’ considerations. Moreover, the perceived influence on oral health and risk thinking emerged as important factors in this theme. The conclusion was that the individual’s relation to the PDS together with his/her health-related attitudes and perceptions were the main factors impacting the choice of payment system in the PDS. A health promotion perspective should be applied, empowering the patients to develop their risk awareness and their own resources.
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| 8. |
- Östberg, Anna-Lena, et al.
(författare)
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Socio-economic and lifestyle factors in relation to priority of dental care in a Swedish adolescent population.
- 2010
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Ingår i: Swedish dental journal. - 0347-9994. ; 34:2, s. 87-94
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this epidemiological survey was to describe and analyze oral health habits and life-style factors in relation to the priority of regular dental care in 19-year-old individuals with specific reference to gender, residential area and socio-economic grouping. The data were generated from a randomized sample of 758 (63%) individuals in three residential areas in Western Sweden (two rural, one urban) who answered a set of questionnaires prior to a dental examination. The analysis revealed that males had significantly less favourable oral health habits than females. Forty-one % of the males and 30% of the females did not plan regular dental visits after the age of 20 when they will be charged for the care (p = 0.002). There were no statistically significant differences in oral health habits and dental care priorities with regard to residential areas and socio-economic groups. In a multivariate model, three significant factors for the probability of "not planning for future regular dental visits" were identified: toothbrushing less than twice daily (OR 1.94; 95% CI 1.28-2.94), smoking (OR 1.68; 95% CI 1.10-2.56) and male gender (OR 1.54; 95% CI 1.05-2.24). The findings emphasize the need for promotion of favourable oral health habits and smoking prevention among adolescents. There is also a need for dental personnel to recognize differences with regard to oral health-related attitudes and behaviours between males and females.
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