Exploring preferences of older adults for dental services: A pilot multi‐national discrete choice experiment

Abstract

ObjectivesTo pilot an exploration of older adults' future preferences using discrete choice experiments to understand who should provide dental examinations and treatment, where these services should be provided, and participants' willingness to pay and willingness to travel.BackgroundThe proportion of older adults in the general population is increasing and is recognised as a pressing public health challenge.Materials and MethodsOlder people aged 65 years and over were recruited into this study from the UK, Switzerland and Greece. Drawing on earlier stakeholder engagement, a set of choice experiments are developed to explore the future preferences of older people for dental examinations and dental treatment, as they anticipated losing their independence. These were presented to the participants using a range of platforms, because of the COVID pandemic. Data were analysed in STATA using a random‐effects logit model.ResultsTwo hundred and forty‐six participants (median age 70 years) completed the pilot study. There was a strong preference across all countries for a dentist to undertake a dental examination (Greece: β = 0.944, Switzerland: β = 0.260, UK β = 0.791), rather than a medical doctor (Greece: β = −0.556, Switzerland: β = −0.4690, UK: β = −0.468). Participants in Switzerland and the UK preferred these examinations to be undertaken in a dental practice (Switzerland: β = 0.220, UK: β = 0.580) while participants in Greece preferred the dental examination to be undertaken in their homes (β = 1.172). Greek participants preferred dental treatment to be undertaken by a specialist (β = 0.365) in their home (β = 0.862), while participants from the UK and Switzerland preferred to avoid any dental treatment at home (Switzerland: β = −0.387; UK: β = −0.444). Willingness to pay analyses highlighted that participants in Switzerland and the UK were willing to pay more to ensure the continuity of future service provision at a family dental practice (Switzerland: β = 0.454, UK: β = 0.695).ConclusionDiscrete choice experiments are valuable for exploring older people's preferences for dental service provision in different countries. Future larger studies should be conducted to further explore the potential of this approach, given the pressing need to design services that are fit for purpose for older people. Continuity of dental service provision is considered as important by most older people, as they anticipate losing their dependence.

Ageism scale for dental students (ASDS): A focus group review of content validity

“…Recent research has directly investigated the preferences of older adults regarding dental care, its provision and providers in the UK, Greece, and Switzerland, and it is important to note that some of those preferences differed by country. 26 However, assumptions about patient preference for older adults are not unique to the field of dentistry. 3 A study about identifying surgical options for patients with breast cancer found that medical providers "demonstrate an age bias against older women in their recommendations of breast conservation and breast reconstruction."…”