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- Pälvärinne, Raimo
(author)
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Considerations on Swedish Dental Care : from leadership to patient satisfaction
- 2019
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Licentiate thesis (other academic/artistic)abstract
- The thesis consists of two papers which are based on a researchproject called ‘Considerations on Swedish Dental Care’. The aimsof the project were to analyse the characteristics of leadership in thepublic dental service (PDS) in Sweden (Paper I) and to study anddescribe patients’ opinions of dental care provided by the PDS andin private dentistry (Paper II).The aim of the first study was to investigate how experienced chiefdental officers (CDOs) in the PDS managed to maintain a marketposition at a time of social change and increased competition froma changing private sector. The CDOs, who have held a leading positionfor at least five years, were asked to participate in the study. Anempirical study with a qualitative design was conducted. Data from16 CDOs were collected in September-October 2014, with a 75%response rate. The aim of the second study was to investigate adults’ experiencesand opinions of the dental care they have received over time frombeing 50 years old to 70 years old. Patients’ dental visiting patterns,satisfaction with care and oral health measured as numbers of teethwere compared between the two care-provision sectors, public andprivate. In addition, a follow-up was conducted among those whoclaimed to have visited only the public sector or the private sectorand those who claimed to have used both sectors during the wholestudy period. Both studies may be of wider interest when examining Swedishdentistry:a) there are no studies of the characteristics of the top leadershipin the Swedish PDS. The PDS in Sweden differs a great dealfrom the PDS in other countries, as it covers much more of themarket and accounts for almost 45% of the total oral healthcaremarket in Sweden;b) there are no previous studies in Sweden, where a comparison ofpatients’ opinions of care in the two sectors of care providers inSweden is made in this way. The findings in Paper I underscore the fact that CDOs in the PDSexert a great deal of effort to consolidate the actual market position.The PDS is also “open” to patients of all kinds, not only to children,adolescents and special needs groups, and it also offers specialist care,which is unusual in many other countries.Paper II shows that patients who visited the PDS had a slightly poorerdental status, compared with the private patients. Both groups lostteeth during a 20-year period and almost at the same level. AlthoughCDOs in the first study focused on maintaining a strong marketposition, the patients in the second study reported greater satisfactionand a more frequent visiting pattern in private dental care comparedwith the PDS. To summarise, this thesis aims to illustrate the spirit of the top managementin the Swedish PDS and to explore adult patients’ opinionsand experience of care in the two provider sectors in Swedish oralhealth care.
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| 2. |
- Pälvärinne, Raimo, et al.
(author)
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Visitors' experiences of public and private dental care in Sweden in 1992-2012
- 2019
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In: BDJ Open. - : Nature Publishing Group. - 2056-807X. ; 5:12
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Journal article (peer-reviewed)abstract
- Aim: The aim was to compare adult patients' experiences of public and private dental care in Sweden over time from the ages of 50 and 70 years, between 1992 and 2012. Materials and methods: Data on visiting patterns, oral health, fees and satisfaction were obtained from a questionnaire study every 5 years in 1992-2012 and analysed by using the Chi-square test and logistic regression. In the present study, the answers given by 6083 respondents in 1992 and 5220 in 2012 were included. Results: Of the 50-year olds, 73.5% had visited the private sector and 26.5% the public sector. In 1992, patients in the public dental service (PDS) had visited their dentists less frequently and experienced having a slightly poorer dental status compared with private patients. After 20 years (2012), the distribution of patients between the two sectors was almost the same (71.4% and 28.8%) and the differences in visiting pattern and dental health persisted. During the study period, 21.6% of the patients changed treatment sector. A small proportion of patients had high treatment costs. A larger proportion of the private sector visitors than the PDS visitors were consistently satisfied with the dental care they had received. Conclusions: As a whole, most adult patients in Sweden were satisfied with their dental care at both public and private clinics.
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| 3. |
- Pälvärinne, Raimo, et al.
(author)
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The healthcare system and the provision of oral healthcare in European Union member states. Part 9: Sweden
- 2018
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In: British Dental Journal. - : Springer Science and Business Media LLC. - 0007-0610 .- 1476-5373. ; 224:8, s. 647-651
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Journal article (peer-reviewed)abstract
- Equally accessible and affordable dental services for all population groups have been a political goal in Sweden for almost a century. All political parties have shared the idea that a person's social background should not have consequences for his or her dental status. Strategic tools to achieve this ambitious goal have been the wide use of publicly provided oral healthcare services, covering even sparsely populated areas, focusing on preventive care and significant subsidies for necessary treatments. Besides free care for children and young adults, oral healthcare is reimbursed from public funds. The public subsidy was particularly generous in 1975-1999 when a 'full clearance' of adults' dentitions was undertaken both by the public and private providers under fixed prices and high reimbursement levels for all treatment measures. Today, preventive oral healthcare for the elderly is given higher priority as most Swedes have been able to keep their natural teeth. © 2018 Nature Publishing Group. All Rights Reserved.
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| 4. |
- Pälvärinne, Raimo, et al.
(author)
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The Public Dental Service in Sweden : An Interview Study of Chief Dental Officers
- 2018
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In: Journal of International Society of Preventive and Community Dentistry. - : Medknow Publications. - 2231-0762. ; 8:3, s. 205-211
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Journal article (peer-reviewed)abstract
- Objective: The aim of this study was to investigate how the Public Dental Service (PDS) in Sweden has managed to maintain a market position at a time of change in political ideologies and increased competition from a growing private sector. Materials and Methods: All Chief Dental Officers (CDOs), who had held this leading position for at least 5 years (n = 22), were asked to participate in a semi-structured telephone interview. Sixteen of the 22 CDOs participated in this study. The questions were sent by mail in 2014 before the telephone interviews, which were audiotaped, transcribed and analyzed using a qualitative analytical approach. Since this was a quality study with just few participants, no statistical analysis was carried out. Results: All the CDOs answered that they had influenced outcomes through brand building and core value work, related to both patients and employees, and to a lesser extent through competitor analysis. Some CDOs had a slightly different approach to the way they described visions, strategies and short-term goals. They used more business-oriented concepts, such as customers, market shares, and profits. Most CDOs regarded their actions as important for the successful development of their organization. Conclusions: The PDS appears to have a stable, strong position in the Swedish dental care market, and a great deal of effort has been put into consolidating this position.
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