Supply Of Dentists Research Articles

Managed care and dental education and research: should academicians be concerned?

This paper examines the restructuring of the delivery system resulting from managed care. As HMOs consolidate to a few large companies in urban areas, they put great pressure on medical providers to reduce their costs and excess delivery capacity. In this environment, academic health centers face serious problems, because HMOs are reluctant to pay their higher charges, and public educational subsidies are declining. Managed care is unlikely to have the same impact on dentistry. Although managed dental care is growing, most Americans will not be enrolled, since they do not have dental insurance. Also, the supply of dentists is starting to decline, increasing the relative demand for dental services. Managed care will have only a limited direct impact on most dental schools, but a significant indirect effect. As academic health center budgets are reduced, all health professional schools can expect to contribute to solving the financial problems of University hospitals and medical schools. The response of dental academicians to these challenges will determine the future of dental education and research for the next decade. Bold new initiatives are needed to find new sources of revenue to support educational and research programs.

Supplier inducement--its relative effect on demand and utilization.

The present study examined the relative effect of supplier inducement on demand as opposed to on utilization. Supply of dentists was measured as population: dentist ratio at the level of trade areas. The dependent variable was number of dental visits during the last year. The probability of having any visit was used as the measure of demand. Number of visits, conditional upon having any visit, was used as the measure of utilization. The data were analyzed using Tobit analysis. This analysis gave the fraction of the total effect of a marginal increase in supply that is due to an increase in utilization as opposed to an increase in demand. The analysis was performed on a national sample comprising 1186 adult Norwegians. Supplier inducement had nearly the same effect on demand as on utilization. This finding may be a result of the payment system for dental care, which relates each item of service to the average time it takes to perform that item. Income opportunities for dentists are then fairly independent of whether they spend their time doing check-ups or treatment. The finding indicates that supplier induced demand is a factor to consider in addition to supplier induced utilization when one tries to explain how supplier inducement may affect the unequal distribution of dentists.

Attributes of growth in the U.S. dental economy, 1950–89

Previous research has established dentistry as a growth sector of the U.S. economy. This study examines the economic relationship between dentistry's growth and factors operating on the demand and supply sides of the dental market. Output, defined as real per capita dental expenditures, was hypothesized to be a function of consumer income, dental insurance and the supply of dentists. Data for the period 1950-89, were analyzed using a generalized least squares approach. The analysis supported the hypothesis, indicating a significant relationship between growth in the dental sector and economic market factors. The study concludes that dentistry's real growth since 1950 was: (1) induced by increases in demand, mainly attributable to insurance and to a lesser extent consumer incomes; and (2) supported by increases in supply. The findings provide support for the insurance hypothesis, which suggests that growth in dental insurance has had a significant impact on the dental economy in recent years.

The influence of dentist supply on the relationship between fluoridation and restorative care among children.

Because fluoridation effectively reduces dental caries among children, it may also reduce their demand for dental care. The authors tested this proposition among 985 insureds aged 9 to 14 in Washington State using dental claims from 1982 to 1985. In the sample almost two thirds of the children with continuous fluoridation exposure lived in markets with the smallest number of persons per dentist. Relative to other children, these children received more diagnostic and preventive services and had the highest probability of receiving restorative care. Among children who received restorations, children in this group had the fewest restorations. While the last result reflects expected reductions in caries due to fluoridation, the others may reflect providers' response to less tooth decay and increased competition for patients.

Dental Manpower

A recent report by the Department of Health and Society Security (DHSS) has argued that a 10% reduction in the intake to dental schools is needed if an oversupply of dentists over the next forty years is to be avoided. Whilst welcoming this recommendation it is likely that it may not go far enough. In this article we describe the approach used in the DHSS report to estimate the demand for and supply of dental care and examine the relevance and implications of the methods used and assumptions made in that report.It is argued that the use of extrapolations of past trends and the absence of sensitivity analysis in much of the analysis implies that little confidence can be placed in the estimates and that on balance the conclusions of the report are likely to lead to an excess supply of dentists over the next forty years. Recommendations are made for improving the planning of the future supply of dentists.

Dental manpower: a transitional matrix analysis of study.

The projected supply of dentists in Australia up to 1991 was analysed using a transitional matrix model. The analysis illustrated the importance of selection of baseline data on the stock of dentists and the sensitivity of the projections of supply to assumptions on recruitment of Australian graduates and to migration of foreign dentists into Australia. The analysis also provided data on the changing age distribution of Australian dentists and the rates of wastage from the dental manpower stock. Directions for further development of a transitional matrix model for the study of dental manpower are discussed.

The impact of prepayment on the economics of dental care

It is anticipated that, during the next few years, there will be a sudden and substantial expansion in the extent of insurance of prepayment coverage against the expenses of dental care. Speculations are offered as to the effect such an expansion will have on expenditures for dental care, dentists’ incomes and fees, supply and distribution of dentists, and use of services.

The Place of Behavioral Science in Dental Public Health

Behavioral research was noted as important to the dental public health practitioner in helping him fulfill his functions of “research, education, prevention, diagnosis, prescription, treatment, and evaluation in community dental health care.” Four dental public health questions were presented: (1) can greater use be made of auxiliary personnel in order to increase dental care for the population; (2) how can the supply of dentists be increased to provide care for a population that is growing in size and raising its socioeconomic levels; (3) why is the fluoridation of water supplies rejected in so many communities; and (4) how can the number of people who go to dentists be increased. Behavioral research findings relevant to answering certain research questions which grow out of these administrative questions were supplied. It was noted that some answers to these questions are now available. However, the youth of social research as a part of dental public health precludes full answers for the practitioner at this time. It seems important to comment on the fact that the summary of social research in dentistry prepared by the present author in 1959 (and unfortunately not published until 1961) now seems almost out of date. Most of the research referred to in this paper was published since 1959, or is still in progress. It seems obvious that the dental public health practitioner has become aware of the value of behavioral research, and will continue to make maximum use of its contributions. Such research in dental public health seems likely to move from its present diagnostic phase to an experimental phase in the near future. Behavioral science activity is expected to be of even more value to the practitioner in its new phase.

Health manpower, 1930-75

H EALTH manpower is a matter of increasing concern to the United States in view of the ra,pid rate of growth of the population. The number of persons in the 48 States and the District of Columbia in mid-1959 is estimated at 177,128,000; by 1975 it is predicted to be 235,246,000, an increase of 33 percent. Whether an adequate supply of physicians, dentists, nurses, and other health personnel can be provided for the future depends on immediate planning for increased numbers of graduates in the health professions within the next few years.

Health Manpower, 1930-75

H EALTH manpower is a matter of increasing concern to the United States in view of the ra,pid rate of growth of the population. The number of persons in the 48 States and the District of Columbia in mid-1959 is estimated at 177,128,000; by 1975 it is predicted to be 235,246,000, an increase of 33 percent. Whether an adequate supply of physicians, dentists, nurses, and other health personnel can be provided for the future depends on immediate planning for increased numbers of graduates in the health professions within the next few years.

The growing shortage of dentists in the United States.

THE STORY of the United States since the end of World War II is a story of great growth and change and technical advance. Our cities are bigger, our buildings are taller, and our children are more numerous-and harder to control. Dishpan hands have been cured by the automatic dishwasher and our cars are now so long we cannot park them. Even Jello has added a couple of new delicious flavors-and perpetual motion has been discovered carrying a guitar. In short, we live in an exciting age. Today's discovery makes yesterday's miracle a commonplace-and who is to say what tomorrow will bring. But what tomorrow will bring is a question we today would be wise to ask, and we should not ask it lightly as a tribute to our own inventiveness, but seriously, as a question basic to human welfare. More children require more schools. More cars require more highways. A new technology means a need for new technicians. Growth means change, and stimulating though it is, change can become chaos unless we are prepared for it. This is true in education. It is true in transportation and in industry. It is even more true in public health. For surely, preparation and planning in a field as -vital to our welfare as health services cannot wait until tomorrow. It must begin today. In the area of dental manpower resources today is none too soon. The fact that we have been losing ground steadily in our effort to supply needed services to our people is not new. The supply of dentists in this country has been lagging behind the growth of the population for more than a quarter of a century. Ironically enough, this decline began as a result of a successful and muchneeded effort by the dental profession to raise the educational standards of our dental schools. This occurred in the 1920's, and the subsequent closing of unaccredited and substandard schools meant a sharp decrease in dental school enrollments. Enrollments continued to fall off during the depression years and by the time World War II began we were not graduating enough dentists to replace those who died or retired. The war ended over a decade ago. We have added new schools and increased classroom space in the old ones until today the schools are graduating nearly twice as many students as they were in the last year before the war began. And yet, the shortage has grown

General Health and Dental Hygiene in Mexico

IN a recent paper (Bol. Of. San. Panamericana, 21, 643 ; 1942) read before the Third Medico-Dental Convention at Mexico City, Dr. Miguel E. Bustamante discusses the development of public health dentistry in Mexico. At the present time the Department of Sanitary Specialization, which is maintained jointly by the Public Health Department and the International Health Division of the Rockefeller Foundation, provides free dental care by the supply of full-time dentists. There are dental services connected with the school health services in forty cities, and in the Federal District dental clinics in dispensaries of the Ministry of Public Assistance are open to adults. In 1940 there were 31 dentists working exclusively for the coordinated services of the various States, and the Public Health Welfare and Education Departments employ an even larger number in the Federal District. Within recent years dentists have collaborated with doctors, sanitary engineers, nurses and laboratory workers in the task of preventive medicine instead of confining themselves to the treatment of patients already suffering from infections of the mouth. The increased interest taken in dental hygiene is shown by the attention given to the patient's previous diseases, the chemical composition of his drinking water, the kind of food he eats and, in the case of children, the health condition of the parents, and the diet of the child from an early age. Prenatal hygiene followed by correct child nutrition and prevention of contagious diseases such as measles, whooping-cough and smallpox, greatly contribute to dental hygiene.