Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment
Identifieur interne : 002554 ( Ncbi/Merge ); précédent : 002553; suivant : 002555Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment
Auteurs : Catherine E. Exley [Royaume-Uni] ; Nikki S. Rousseau [Royaume-Uni] ; Jimmy Steele [Royaume-Uni] ; Tracy Finch [Royaume-Uni] ; James Field [Royaume-Uni] ; Cam Donaldson [Royaume-Uni] ; J Mark Thomason [Royaume-Uni] ; Carl R. May [Royaume-Uni] ; Janice S. Ellis [Royaume-Uni]Source :
- BMC Health Services Research [ 1472-6963 ] ; 2009.
Abstract
The aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments – such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them.
Mixed methods will be employed to provide insight and understanding into how clinical need is determined, and what influences people's decision making processes when deciding whether or not to pursue a dental implant treatment. Phase 1 will use a structured scoping questionnaire with all the General dental practitioners (GDPs) in three Primary Care Trust areas (n = 300) to provide base-line data about existing practice in relation to dental implant treatment, and to provide data to develop a systematic sampling procedure for Phase 2. Phases 2 (GDPs) and 3 (patients) use qualitative focused one to one interviews with a sample of these practitioners (up to 30) and their patients (up to 60) to examine their views and experiences of decision making in relation to dental implant treatment. Purposive sampling for phases 2 and 3 will be carried out to ensure participants represent a range of socio-economic circumstances, and choices made.
Most dental implant treatment is conducted in primary care. Very little information was available prior to this study about the quantity and type of treatment carried out privately. It became apparent during phase 2 that ISOD treatment was an unusual treatment in primary care. We thus extended our sample criteria for Phase 3 to include people who had had other implant supported restorations, although not single tooth replacements.
Url:
DOI: 10.1186/1472-6963-9-7
PubMed: 19138389
PubMed Central: 2637853
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PMC:2637853Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments – such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them.</p>
</sec>
<sec><title>Methods/Design</title>
<p>Mixed methods will be employed to provide insight and understanding into how clinical need is determined, and what influences people's decision making processes when deciding whether or not to pursue a dental implant treatment. Phase 1 will use a structured scoping questionnaire with all the General dental practitioners (GDPs) in three Primary Care Trust areas (n = 300) to provide base-line data about existing practice in relation to dental implant treatment, and to provide data to develop a systematic sampling procedure for Phase 2. Phases 2 (GDPs) and 3 (patients) use qualitative focused one to one interviews with a sample of these practitioners (up to 30) and their patients (up to 60) to examine their views and experiences of decision making in relation to dental implant treatment. Purposive sampling for phases 2 and 3 will be carried out to ensure participants represent a range of socio-economic circumstances, and choices made.</p>
</sec>
<sec><title>Discussion</title>
<p>Most dental implant treatment is conducted in primary care. Very little information was available prior to this study about the quantity and type of treatment carried out privately. It became apparent during phase 2 that ISOD treatment was an unusual treatment in primary care. We thus extended our sample criteria for Phase 3 to include people who had had other implant supported restorations, although not single tooth replacements.</p>
</sec>
</div>
</front>
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<journal-title>BMC Health Services Research</journal-title>
<issn pub-type="epub">1472-6963</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
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<article-meta><article-id pub-id-type="pmid">19138389</article-id>
<article-id pub-id-type="pmc">2637853</article-id>
<article-id pub-id-type="publisher-id">1472-6963-9-7</article-id>
<article-id pub-id-type="doi">10.1186/1472-6963-9-7</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Study Protocol</subject>
</subj-group>
</article-categories>
<title-group><article-title>Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment</article-title>
</title-group>
<contrib-group><contrib id="A1" corresp="yes" contrib-type="author"><name><surname>Exley</surname>
<given-names>Catherine E</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>catherine.exley@ncl.ac.uk</email>
</contrib>
<contrib id="A2" contrib-type="author"><name><surname>Rousseau</surname>
<given-names>Nikki S</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>n.s.rousseau@ncl.ac.uk</email>
</contrib>
<contrib id="A3" contrib-type="author"><name><surname>Steele</surname>
<given-names>Jimmy</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>jimmy.steele@ncl.ac.uk</email>
</contrib>
<contrib id="A4" contrib-type="author"><name><surname>Finch</surname>
<given-names>Tracy</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>tracy.finch@ncl.ac.uk</email>
</contrib>
<contrib id="A5" contrib-type="author"><name><surname>Field</surname>
<given-names>James</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>james.field@ncl.ac.uk</email>
</contrib>
<contrib id="A6" contrib-type="author"><name><surname>Donaldson</surname>
<given-names>Cam</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>cam.donaldson@ncl.ac.uk</email>
</contrib>
<contrib id="A7" contrib-type="author"><name><surname>Thomason</surname>
<given-names>J Mark</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>j.m.thomason@ncl.ac.uk</email>
</contrib>
<contrib id="A8" contrib-type="author"><name><surname>May</surname>
<given-names>Carl R</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>c.r.may@ncl.ac.uk</email>
</contrib>
<contrib id="A9" contrib-type="author"><name><surname>Ellis</surname>
<given-names>Janice S</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>j.s.ellis@ncl.ac.uk</email>
</contrib>
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<aff id="I1"><label>1</label>
Institute of Health and Society, 21 Claremont Place, Newcastle University, Newcastle upon Tyne, NE2 4AA, UK</aff>
<aff id="I2"><label>2</label>
School of Dental Sciences, Framlington Place, Newcastle University, Newcastle upon Tyne, NE2 4BW, UK</aff>
<pub-date pub-type="collection"><year>2009</year>
</pub-date>
<pub-date pub-type="epub"><day>12</day>
<month>1</month>
<year>2009</year>
</pub-date>
<volume>9</volume>
<fpage>7</fpage>
<lpage>7</lpage>
<ext-link ext-link-type="uri" xlink:href="http://www.biomedcentral.com/1472-6963/9/7"></ext-link>
<history><date date-type="received"><day>24</day>
<month>11</month>
<year>2008</year>
</date>
<date date-type="accepted"><day>12</day>
<month>1</month>
<year>2009</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2009 Exley et al; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2009</copyright-year>
<copyright-holder>Exley et al; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0"></ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p>
<pmc-comment>
Exley
E
Catherine
catherine.exley@ncl.ac.uk
Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment
2009 BMC Health Services Research 9(1): 7-. (2009) 1472-6963(2009)9:1<7> urn:ISSN:1472-6963 </pmc-comment>
</license>
</permissions>
<abstract><sec><title>Background</title>
<p>The aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments – such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them.</p>
</sec>
<sec><title>Methods/Design</title>
<p>Mixed methods will be employed to provide insight and understanding into how clinical need is determined, and what influences people's decision making processes when deciding whether or not to pursue a dental implant treatment. Phase 1 will use a structured scoping questionnaire with all the General dental practitioners (GDPs) in three Primary Care Trust areas (n = 300) to provide base-line data about existing practice in relation to dental implant treatment, and to provide data to develop a systematic sampling procedure for Phase 2. Phases 2 (GDPs) and 3 (patients) use qualitative focused one to one interviews with a sample of these practitioners (up to 30) and their patients (up to 60) to examine their views and experiences of decision making in relation to dental implant treatment. Purposive sampling for phases 2 and 3 will be carried out to ensure participants represent a range of socio-economic circumstances, and choices made.</p>
</sec>
<sec><title>Discussion</title>
<p>Most dental implant treatment is conducted in primary care. Very little information was available prior to this study about the quantity and type of treatment carried out privately. It became apparent during phase 2 that ISOD treatment was an unusual treatment in primary care. We thus extended our sample criteria for Phase 3 to include people who had had other implant supported restorations, although not single tooth replacements.</p>
</sec>
</abstract>
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<name sortKey="May, Carl R" sort="May, Carl R" uniqKey="May C" first="Carl R" last="May">Carl R. May</name>
<name sortKey="Rousseau, Nikki S" sort="Rousseau, Nikki S" uniqKey="Rousseau N" first="Nikki S" last="Rousseau">Nikki S. Rousseau</name>
<name sortKey="Steele, Jimmy" sort="Steele, Jimmy" uniqKey="Steele J" first="Jimmy" last="Steele">Jimmy Steele</name>
<name sortKey="Thomason, J Mark" sort="Thomason, J Mark" uniqKey="Thomason J" first="J Mark" last="Thomason">J Mark Thomason</name>
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