Does competition affect the clinical decision‐making of dentists? A geospatial analysis

Ghoneim, Abdulrahman; Yu, Bonnie; Lawrence, Herenia P.; Glogauer, Michael; Shankardass, Ketan; Quiñonez, Carlos

doi:10.1111/cdoe.12514

Cited by 9 publications

(10 citation statements)

References 28 publications

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“…In Korea, physicians and dentists are remunerated based on fee‐for‐services, and the number of practicing dentists per 100,000 individuals has continued to rise from 0.31 in 2000 to 0.49 in 2017 20 . Fee‐for‐service tends to increase the volume of medical services than the salary system, 21,22 and an increase in physician density tends to lead to physician‐induced demand 23‐26 . These factors may be responsible for the increase in volume of dental treatments.…”

Section: Discussionmentioning

confidence: 99%

Age, period and cohort trends in oral health status in South Korean adults

Kim

Jung

2020

Comm Dent Oral Epid

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Objectives The purpose of this study was to identify the age, period and cohort effects on the changes in oral health status in South Koreans. Methods The age, period and cohort analysis (APC analysis) of the oral health status was conducted using an aggregated age‐by‐time period table. The age‐by‐time period table was formulated using data from the Korea National Oral Health Survey (KNOHS) 2000 and 2006, and the Korea National Health and Nutrition Examination Survey (KNHANES) 2010 and 2015. Two oral health outcomes were measured: the number of teeth and Decayed‐Missing‐Filled Teeth (DMFT) index. Descriptive analysis by graphical representation and partial least square (PLS) regression was used for APC analysis. Results Both graphical description and PLS regression showed age and cohort effects in oral health status with the number of teeth decreasing and the DMFT index increasing with age. No period effects were found in either index. The number of teeth increased in the recent birth cohorts. However, the DMFT index showed a reverse J‐shaped trend, which worsened in recent birth cohorts. The DMFT index increase in the recent cohort was mainly attributed by an increase in the FT index. Conclusions The effects of age on the number of teeth and caries highlight the importance of oral health in adulthood. The increased caries experience in recent cohorts may indicate the limitations of the current oral health policy. It would be relevant to explore what determinants cause the changes in oral health status. Future oral health policies should address the new directions to reduce the burden of oral diseases.

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Section: Discussionmentioning

confidence: 99%

Age, period and cohort trends in oral health status in South Korean adults

Kim

Jung

2020

Comm Dent Oral Epid

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“…The data for this study came from a larger study, which employed a 46‐item survey with questions based on factors that the literature suggests has a relationship to treatment decision‐making . It included questions on demographic characteristics, such as age and gender of the dentist; practice characteristics, such as age of the practice and number of hygienists employed; and professional characteristics, such as opinions on professional responsibilities.…”

Section: Methodsmentioning

confidence: 99%

“…The data for this study came from a larger study, which employed a 46-item survey with questions based on factors that the literature suggests has a relationship to treatment decision-making. 17,18 It included questions on demographic characteristics, such as age and gender of the dentist; practice characteristics, such as age of the practice and number of hygienists employed; and professional characteristics, such as opinions on professional responsibilities. There were also questions to assess dentists' perceptions about personal and market pressures, such as the size of student and practice loans and satisfaction with the level of busyness in their dental practices.…”

Section: Survey Creationmentioning

confidence: 99%

Perceived professional roles and implications for clinical decision‐making

Ghoneim

Lawrence

et al. 2019

J Public Health Dent

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Objectives This study aims to (a) investigate the relationship between dentists' perceived professional role (PPR), defined as the belief that they are health care professionals versus business people, and treatment intensity, determined by the aggressiveness of clinical approaches, such as in number or scope, and (b) identify the demographic and practice characteristics that have a relationship to PPR. Methods A 46‐item survey with questions on dentists' demographic and professional characteristics was mailed to a random sample of 3,201 general dentists in Ontario, Canada. PPR was measured by visual analog scale and by Likert‐type scale questions, which have been validated in the literature in terms of their ability to measure PPR. Treatment intensity was measured by a set of case scenarios. Univariate, bivariate, and multivariable analyses were performed. Results One‐thousand and seventy‐five dentists returned usable surveys (33.6% response rate). When using the two methods to measure PPR, visual analog scale and Likert‐type scale questions, dentists who identified as business people tended to have a higher treatment intensity compared to those who identified as health care professionals (p < 0.1 and p < 0.05, respectively). In multivariable logistic regression, years of practice, number of technologies used in a practice, and perceiving other dentists as competitors rather than colleagues were significant predictors of identifying as a business person. Conclusions Dentists' PPRs had a significant relationship to the aggressiveness of treatment decisions. Demographic and practice characteristics also had significant relationships to PPR. These findings may have implications for public trust and dentistry's status as a health care profession.

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“…Dentists located in regions with competitive pressure from other dentists presented an odds 63% higher to indicate a more aggressive approach than dentists located in medium competitive regions. Also, the dentist in very low competitive areas presented an odds 31% higher to indicate aggressive dentistry treatments when compared with medium density regions 28 . Therefore, considering the Brazilian and Guatemalan distribution of dental schools and Dentists we found some differences that could help us.…”

Section: Discussionmentioning

confidence: 96%

“…Some patient's characteristics could influence the decision making of health professionals [25][26][27] . Moreover, it was observed that competition affected the clinical decision-making of dentists in Canada 28 . Dentists located in regions with competitive pressure from other dentists presented an odds 63% higher to indicate a more aggressive approach than dentists located in medium competitive regions.…”

Section: Discussionmentioning

confidence: 99%

Dentist’s preferences on vital and nonvital tooth bleaching

et al. 2021

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Aim: The present study aimed to investigate if the Guatemalan dentist’s options on tooth bleaching could be influenced by their time in clinical practice, the level of specialization or their working place. Methods: A representative sample of dentists working in clinical practice in Guatemala was selected. Data were collected using a self-administered questionnaire with information related to gender, professional characteristics (time since graduation in years and working place) and preferences regarding vital (at-home or in-office; type and concentration of bleaching agent) and the nonvital tooth bleaching (bleaching agent used). The analysis was performed and the association between preference for bleaching technique and independent variables were investigated using Fisher’s exact test. Results: 200 dentists were interviewed. More than half of dentists were male (57.0%) with time since graduation between 11 and 20 years (n= 64; 32.3%). Dentists mostly (60.5%) preferred in-office technique for vital bleaching, with 10-20% Carbamide peroxide (CP) as the preferred agent (50%). For nonvital teeth, the preferred agent (46.8%) was 37% Hydrogen Peroxide (HP). About the associations, younger dentists (< 20 years of graduation) selected mostly in-office technique, while those with more than 20 years indicated more the at-home technique. Also, the dentists working in private practice chose more frequently in-office technique. Thus, the in-office technique was more popular among Guatemalan dentists, with 10-20% CP and 37% HP selected as favorite bleaching agents for vital and nonvital techniques, respectively. Conclusion: The time of clinical practice and working place influenced some choices.

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Does competition affect the clinical decision‐making of dentists? A geospatial analysis

Cited by 9 publications

References 28 publications

Age, period and cohort trends in oral health status in South Korean adults

Age, period and cohort trends in oral health status in South Korean adults

Perceived professional roles and implications for clinical decision‐making

Dentist’s preferences on vital and nonvital tooth bleaching

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