Dental decisionmaking and variation in dentist service rates
Identifieur interne : 00B555 ( Main/Exploration ); précédent : 00B554; suivant : 00B556Dental decisionmaking and variation in dentist service rates
Auteurs : David Grembowski [États-Unis] ; Peter Milgrom [États-Unis] ; Louis Fiset [États-Unis]Source :
- Social Science & Medicine [ 0277-9536 ] ; 1991.
Descripteurs français
- Wicri :
- topic : Dentiste, Classe sociale.
English descriptors
- KwdEn :
- Alternative treatments, Amalgam, Average number, Bridge crowns, Busyness market insurance fluoridation practice beliefs, Canal, Clinical decisionmaking, Counterintuitive result, Crown root canal therapy, Data analysis, Decisionmaking, Dental care, Dental claims, Dental decisionmaking, Dental insurance, Dental practice, Dental services, Dental studies report, Dentist, Dentist fees, Dentist service rates, Denture, Dentures bridge crowns, Dummy variables, Edentulous strength, Environmental characteristics, Extraction, Extraction services, Factor analysis, Fewer crown, Fewer crowns, Fluoridation, General practitioners, Health care policy, Higher rates, Important factor, Independent variables, Initial mailing, Little variation, Lower rates, Major source, Medical care, Medical practice, More crowns, More services, Negative correlations, Negative effect, Negative effects, Older dentists, Opposite beliefs, Opposite rankings, Oral health, Orientation patient influence information, Other factors, Partial dentures, Patient factors, Patient preference, Patient preferences, Periodontal, Periodontal disease, Periodontal status, Pins crowns root canals, Positive association, Positive correlation, Positive effect, Practice beliefs, Practice busyness, Practice profiles, Practice structure, Practice style, Preventive beliefs, Preventive orientation, Preventive services, Previous analyses, Previous analysis, Rate equations, Removable, Root canal, Root canal therapy, Root canals, Service rates, Similar characteristics, Simple extraction, Simple extractions, Small areas, Social class, Sole exception, Standard deviation, Structural features, Survey data, Technical aspects, Technical criteria, Technical factors, Tooth damage, Unexplained variation, Washington education association, Washington state.
- Teeft :
- Alternative treatments, Amalgam, Average number, Bridge crowns, Busyness market insurance fluoridation practice beliefs, Canal, Clinical decisionmaking, Counterintuitive result, Crown root canal therapy, Data analysis, Decisionmaking, Dental care, Dental claims, Dental decisionmaking, Dental insurance, Dental practice, Dental services, Dental studies report, Dentist, Dentist fees, Dentist service rates, Denture, Dentures bridge crowns, Dummy variables, Edentulous strength, Environmental characteristics, Extraction, Extraction services, Factor analysis, Fewer crown, Fewer crowns, Fluoridation, General practitioners, Health care policy, Higher rates, Important factor, Independent variables, Initial mailing, Little variation, Lower rates, Major source, Medical care, Medical practice, More crowns, More services, Negative correlations, Negative effect, Negative effects, Older dentists, Opposite beliefs, Opposite rankings, Oral health, Orientation patient influence information, Other factors, Partial dentures, Patient factors, Patient preference, Patient preferences, Periodontal, Periodontal disease, Periodontal status, Pins crowns root canals, Positive association, Positive correlation, Positive effect, Practice beliefs, Practice busyness, Practice profiles, Practice structure, Practice style, Preventive beliefs, Preventive orientation, Preventive services, Previous analyses, Previous analysis, Rate equations, Removable, Root canal, Root canal therapy, Root canals, Service rates, Similar characteristics, Simple extraction, Simple extractions, Small areas, Social class, Sole exception, Standard deviation, Structural features, Survey data, Technical aspects, Technical criteria, Technical factors, Tooth damage, Unexplained variation, Washington education association, Washington state.
Abstract
Abstract: Previous medical and dental studies report wide variations in service rates across small areas, regions and providers. A major source of this variation appears to be the pattern of clinical decisionmaking of the provider. This argument was tested using dentist service rates (the average number of services provided per patient) calculated from 1984–1985 claims data for a population of well-educated, middle-class patients in Washington state, U.S.A. (N = 23, 153). Service rates were calculated for each dental procedure in the following pairs of alternative treatments: crown vs amalgam or crown build-up; root canal therapy vs extraction; and fixed bridge vs removable partial denture. For each pair, dentists identified patient (e.g. cost, patient preference) and technical (e.g. periodontal status, tooth damage) factors which they considered to be important in choosing therapy. Regression analysis revealed that the technical factors explained little variation in the rates, while at least one patient factor was significant across services, except prosthetics. Environmental characteristics, structural features of the practice, and the dentists' practice beliefs also explained variation in the rates.
Url:
DOI: 10.1016/0277-9536(91)90106-M
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Istex, to step Corpus: 000991
- to stream Istex, to step Curation: 000991
- to stream Istex, to step Checkpoint: 005495
- to stream Main, to step Merge: 00BC64
- to stream Main, to step Curation: 00B555
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Dental decisionmaking and variation in dentist service rates</title>
<author><name sortKey="Grembowski, David" sort="Grembowski, David" uniqKey="Grembowski D" first="David" last="Grembowski">David Grembowski</name>
</author>
<author><name sortKey="Milgrom, Peter" sort="Milgrom, Peter" uniqKey="Milgrom P" first="Peter" last="Milgrom">Peter Milgrom</name>
</author>
<author><name sortKey="Fiset, Louis" sort="Fiset, Louis" uniqKey="Fiset L" first="Louis" last="Fiset">Louis Fiset</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">ISTEX</idno>
<idno type="RBID">ISTEX:140CF87FAEA6D5A38CFAC2224F15D61C2A2A8D03</idno>
<date when="1991" year="1991">1991</date>
<idno type="doi">10.1016/0277-9536(91)90106-M</idno>
<idno type="url">https://api.istex.fr/document/140CF87FAEA6D5A38CFAC2224F15D61C2A2A8D03/fulltext/pdf</idno>
<idno type="wicri:Area/Istex/Corpus">000991</idno>
<idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000991</idno>
<idno type="wicri:Area/Istex/Curation">000991</idno>
<idno type="wicri:Area/Istex/Checkpoint">005495</idno>
<idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">005495</idno>
<idno type="wicri:doubleKey">0277-9536:1991:Grembowski D:dental:decisionmaking:and</idno>
<idno type="wicri:Area/Main/Merge">00BC64</idno>
<idno type="wicri:Area/Main/Curation">00B555</idno>
<idno type="wicri:Area/Main/Exploration">00B555</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title level="a">Dental decisionmaking and variation in dentist service rates</title>
<author><name sortKey="Grembowski, David" sort="Grembowski, David" uniqKey="Grembowski D" first="David" last="Grembowski">David Grembowski</name>
<affiliation wicri:level="4"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Departments of Dental Public Health Sciences, University of Washington, Seattle, WA 98195</wicri:regionArea>
<placeName><region type="state">Washington (État)</region>
<settlement type="city">Seattle</settlement>
</placeName>
<orgName type="university">Université de Washington</orgName>
</affiliation>
</author>
<author><name sortKey="Milgrom, Peter" sort="Milgrom, Peter" uniqKey="Milgrom P" first="Peter" last="Milgrom">Peter Milgrom</name>
<affiliation wicri:level="4"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Departments of Dental Public Health Sciences, University of Washington, Seattle, WA 98195</wicri:regionArea>
<placeName><region type="state">Washington (État)</region>
<settlement type="city">Seattle</settlement>
</placeName>
<orgName type="university">Université de Washington</orgName>
</affiliation>
</author>
<author><name sortKey="Fiset, Louis" sort="Fiset, Louis" uniqKey="Fiset L" first="Louis" last="Fiset">Louis Fiset</name>
<affiliation wicri:level="4"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Departments of Dental Public Health Sciences, University of Washington, Seattle, WA 98195</wicri:regionArea>
<placeName><region type="state">Washington (État)</region>
<settlement type="city">Seattle</settlement>
</placeName>
<orgName type="university">Université de Washington</orgName>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">Social Science & Medicine</title>
<title level="j" type="abbrev">SSM</title>
<idno type="ISSN">0277-9536</idno>
<imprint><publisher>ELSEVIER</publisher>
<date type="published" when="1991">1991</date>
<biblScope unit="volume">32</biblScope>
<biblScope unit="issue">3</biblScope>
<biblScope unit="page" from="287">287</biblScope>
<biblScope unit="page" to="294">294</biblScope>
</imprint>
<idno type="ISSN">0277-9536</idno>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">0277-9536</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Alternative treatments</term>
<term>Amalgam</term>
<term>Average number</term>
<term>Bridge crowns</term>
<term>Busyness market insurance fluoridation practice beliefs</term>
<term>Canal</term>
<term>Clinical decisionmaking</term>
<term>Counterintuitive result</term>
<term>Crown root canal therapy</term>
<term>Data analysis</term>
<term>Decisionmaking</term>
<term>Dental care</term>
<term>Dental claims</term>
<term>Dental decisionmaking</term>
<term>Dental insurance</term>
<term>Dental practice</term>
<term>Dental services</term>
<term>Dental studies report</term>
<term>Dentist</term>
<term>Dentist fees</term>
<term>Dentist service rates</term>
<term>Denture</term>
<term>Dentures bridge crowns</term>
<term>Dummy variables</term>
<term>Edentulous strength</term>
<term>Environmental characteristics</term>
<term>Extraction</term>
<term>Extraction services</term>
<term>Factor analysis</term>
<term>Fewer crown</term>
<term>Fewer crowns</term>
<term>Fluoridation</term>
<term>General practitioners</term>
<term>Health care policy</term>
<term>Higher rates</term>
<term>Important factor</term>
<term>Independent variables</term>
<term>Initial mailing</term>
<term>Little variation</term>
<term>Lower rates</term>
<term>Major source</term>
<term>Medical care</term>
<term>Medical practice</term>
<term>More crowns</term>
<term>More services</term>
<term>Negative correlations</term>
<term>Negative effect</term>
<term>Negative effects</term>
<term>Older dentists</term>
<term>Opposite beliefs</term>
<term>Opposite rankings</term>
<term>Oral health</term>
<term>Orientation patient influence information</term>
<term>Other factors</term>
<term>Partial dentures</term>
<term>Patient factors</term>
<term>Patient preference</term>
<term>Patient preferences</term>
<term>Periodontal</term>
<term>Periodontal disease</term>
<term>Periodontal status</term>
<term>Pins crowns root canals</term>
<term>Positive association</term>
<term>Positive correlation</term>
<term>Positive effect</term>
<term>Practice beliefs</term>
<term>Practice busyness</term>
<term>Practice profiles</term>
<term>Practice structure</term>
<term>Practice style</term>
<term>Preventive beliefs</term>
<term>Preventive orientation</term>
<term>Preventive services</term>
<term>Previous analyses</term>
<term>Previous analysis</term>
<term>Rate equations</term>
<term>Removable</term>
<term>Root canal</term>
<term>Root canal therapy</term>
<term>Root canals</term>
<term>Service rates</term>
<term>Similar characteristics</term>
<term>Simple extraction</term>
<term>Simple extractions</term>
<term>Small areas</term>
<term>Social class</term>
<term>Sole exception</term>
<term>Standard deviation</term>
<term>Structural features</term>
<term>Survey data</term>
<term>Technical aspects</term>
<term>Technical criteria</term>
<term>Technical factors</term>
<term>Tooth damage</term>
<term>Unexplained variation</term>
<term>Washington education association</term>
<term>Washington state</term>
</keywords>
<keywords scheme="Teeft" xml:lang="en"><term>Alternative treatments</term>
<term>Amalgam</term>
<term>Average number</term>
<term>Bridge crowns</term>
<term>Busyness market insurance fluoridation practice beliefs</term>
<term>Canal</term>
<term>Clinical decisionmaking</term>
<term>Counterintuitive result</term>
<term>Crown root canal therapy</term>
<term>Data analysis</term>
<term>Decisionmaking</term>
<term>Dental care</term>
<term>Dental claims</term>
<term>Dental decisionmaking</term>
<term>Dental insurance</term>
<term>Dental practice</term>
<term>Dental services</term>
<term>Dental studies report</term>
<term>Dentist</term>
<term>Dentist fees</term>
<term>Dentist service rates</term>
<term>Denture</term>
<term>Dentures bridge crowns</term>
<term>Dummy variables</term>
<term>Edentulous strength</term>
<term>Environmental characteristics</term>
<term>Extraction</term>
<term>Extraction services</term>
<term>Factor analysis</term>
<term>Fewer crown</term>
<term>Fewer crowns</term>
<term>Fluoridation</term>
<term>General practitioners</term>
<term>Health care policy</term>
<term>Higher rates</term>
<term>Important factor</term>
<term>Independent variables</term>
<term>Initial mailing</term>
<term>Little variation</term>
<term>Lower rates</term>
<term>Major source</term>
<term>Medical care</term>
<term>Medical practice</term>
<term>More crowns</term>
<term>More services</term>
<term>Negative correlations</term>
<term>Negative effect</term>
<term>Negative effects</term>
<term>Older dentists</term>
<term>Opposite beliefs</term>
<term>Opposite rankings</term>
<term>Oral health</term>
<term>Orientation patient influence information</term>
<term>Other factors</term>
<term>Partial dentures</term>
<term>Patient factors</term>
<term>Patient preference</term>
<term>Patient preferences</term>
<term>Periodontal</term>
<term>Periodontal disease</term>
<term>Periodontal status</term>
<term>Pins crowns root canals</term>
<term>Positive association</term>
<term>Positive correlation</term>
<term>Positive effect</term>
<term>Practice beliefs</term>
<term>Practice busyness</term>
<term>Practice profiles</term>
<term>Practice structure</term>
<term>Practice style</term>
<term>Preventive beliefs</term>
<term>Preventive orientation</term>
<term>Preventive services</term>
<term>Previous analyses</term>
<term>Previous analysis</term>
<term>Rate equations</term>
<term>Removable</term>
<term>Root canal</term>
<term>Root canal therapy</term>
<term>Root canals</term>
<term>Service rates</term>
<term>Similar characteristics</term>
<term>Simple extraction</term>
<term>Simple extractions</term>
<term>Small areas</term>
<term>Social class</term>
<term>Sole exception</term>
<term>Standard deviation</term>
<term>Structural features</term>
<term>Survey data</term>
<term>Technical aspects</term>
<term>Technical criteria</term>
<term>Technical factors</term>
<term>Tooth damage</term>
<term>Unexplained variation</term>
<term>Washington education association</term>
<term>Washington state</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Dentiste</term>
<term>Classe sociale</term>
</keywords>
</textClass>
<langUsage><language ident="en">en</language>
</langUsage>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Abstract: Previous medical and dental studies report wide variations in service rates across small areas, regions and providers. A major source of this variation appears to be the pattern of clinical decisionmaking of the provider. This argument was tested using dentist service rates (the average number of services provided per patient) calculated from 1984–1985 claims data for a population of well-educated, middle-class patients in Washington state, U.S.A. (N = 23, 153). Service rates were calculated for each dental procedure in the following pairs of alternative treatments: crown vs amalgam or crown build-up; root canal therapy vs extraction; and fixed bridge vs removable partial denture. For each pair, dentists identified patient (e.g. cost, patient preference) and technical (e.g. periodontal status, tooth damage) factors which they considered to be important in choosing therapy. Regression analysis revealed that the technical factors explained little variation in the rates, while at least one patient factor was significant across services, except prosthetics. Environmental characteristics, structural features of the practice, and the dentists' practice beliefs also explained variation in the rates.</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Washington (État)</li>
</region>
<settlement><li>Seattle</li>
</settlement>
<orgName><li>Université de Washington</li>
</orgName>
</list>
<tree><country name="États-Unis"><region name="Washington (État)"><name sortKey="Grembowski, David" sort="Grembowski, David" uniqKey="Grembowski D" first="David" last="Grembowski">David Grembowski</name>
</region>
<name sortKey="Fiset, Louis" sort="Fiset, Louis" uniqKey="Fiset L" first="Louis" last="Fiset">Louis Fiset</name>
<name sortKey="Milgrom, Peter" sort="Milgrom, Peter" uniqKey="Milgrom P" first="Peter" last="Milgrom">Peter Milgrom</name>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/EdenteV2/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 00B555 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 00B555 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Santé |area= EdenteV2 |flux= Main |étape= Exploration |type= RBID |clé= ISTEX:140CF87FAEA6D5A38CFAC2224F15D61C2A2A8D03 |texte= Dental decisionmaking and variation in dentist service rates }}
This area was generated with Dilib version V0.6.32. |