Patient characteristics in relation to dental care payment model: capitation vs fee for service.

Abstract

To analyse patient profiles in two payment models, the capitation (DCH) and the fee-for-service (FFS) systems, in relation to socioeconomic status, self-reported health and health behavior, as well as patient attitudes to and satisfaction with the DCH model in the Public Dental Service (PDS) in Sweden. The present survey included a random national sample of the adult population in Sweden. A telemarketing company, TNS SIFO, was responsible for the sample selection and telephone interviews conducted in May 2013. The 3,500 adults (aged =19 years) included in the sample gave a participation rate of 49.7%. Individuals choosing DCH were younger. FFS patients rated their health as less good, were less physically active, were more often smokers and had a lower household income. The DCH patients were more satisfied with their payment model than the FFS patients (98% vs 85%). A multivariate analysis showed that three of the variables significantly contributed to the model predicting DCH patients: age, with an odds ratio of 0.95, household income (OR=1.85) and importance of oral health for well-being (OR=2.05). There was a pattern of dimensions indicating the choice of payment model among adult patients in the Swedish Public Dental Service. The patients in DCH had higher socioeconomic position, were younger, rated their oral health as better and were more satisfied with the payment model (DCH) than the patients in the FFS system.