Abstract
Aim: To compare the provision and costs at the point of delivery of dental treatments in a sample of European Union (EU) Member States. Materials and methods: A questionnaire with open-ended questions was sent to oral health policy-makers in Denmark, England, France, Germany, Hungary, Ireland, Italy, the Netherlands, Poland, Romania, Scotland and Spain. They were asked to answer questions on the probable costs and provision of treatment in their country for a vignette presented as a pre-defined case. Results: All respondents returned answers to all questions. Wide variations were reported in: who would deliver care, cost of items of care and total cost. For example, in France, only a dentist would provide the treatment. In Denmark, England, Germany, Ireland, Italy, the Netherlands and Scotland, it was likely that the treatment would be provided by a combination of dentist, dental hygienist and dental nurse. Fees ranged from €72 in England (if treated within the NHS) to €603 in Denmark. In Italy, Spain and for most patients in Romania, all treatment costs were paid by the patient. In the other nine countries, some subsidy from public funds was available. In terms of percentage of per capita Gross National Income, the cost to the patient ranged from 0.12% in France to 1.57% in Spain. Conclusions: It was apparent that there are wide variations between EU Member States in the manner in which oral healthcare is delivered, its cost and the extent to which the cost of treatment is subsidised from state funds or through private insurance.
Highlights
Six systems have been described for the provision of oral healthcare in Europe[1]
It is clear that there are wide variations between countries across Europe in the manner in which clinical oral health services are delivered to patients[1,2]
The studies that have been performed have invariably investigated the total spend on oral healthcare in countries, and the proportions funded by public and private sources[13,14,15,16] or on total expenditure on oral health in European countries[17,18]
Summary
Six systems have been described for the provision of oral healthcare in Europe[1]. They have been termed Nordic, Bismarkian, Beveridgian, Southern European, Eastern European and Hybrid (publicly funded [free] oral healthcare for some or all children but largely private provision for adults). It is clear that there are wide variations between countries across Europe in the manner in which clinical oral health services are delivered to patients[1,2]. The costs of delivery of care vary greatly between countries. In a study of nine European Union (EU) Member States, England was found to be the most costly system for the delivery of dental care[3]. The study used a restricted vignette about the costs of placing a single amalgam restoration in a child, it was estimated that in 2005 the mean cost of such treatment across
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