Practice Characteristics Associated with Patient‐Specific Receipt of Dental Diagnostic Radiographs

Abstract

Objective. To quantify the role of practice characteristics in patient-specific receipt of dental diagnostic radiographic services. Data Source/Study Setting. Florida Dental Care Study (FDCS). Study Design. The FDCS was a 48-month prospective observational cohort study of community-dwelling adults. Participants' dentists were asked to complete a questionnaire about their practice characteristics. Data Collection/Extraction Methods. In-person interviews and clinical examinations were conducted at baseline, 24, and 48 months, with 6-monthly telephone interviews in between. A single multivariate (four radiographic service outcomes) multivariable (multiple explanatory covariates) logistic regression was used to model service receipts. Principal Findings. These practice characteristics were significantly associated with patient-specific receipt of radiographic services: number of different practices attended during follow-up; dentist's rating of how busy the practice was; typical waiting time for a new patient examination; practice size; percentage of patients that the dentist reported as interested in details about the condition of their mouths; percentage of African American patients in the practice; percentage of patients in the practice who do not have dental insurance; and dentist's agreement with a statement regarding whether patients should be dismissed from the practice. Effects had differential magnitudes and directions of effect, depending upon radiograph type. Conclusions. Practice characteristics were significantly associated with patientspecific receipt of services. These effects were independent of patient-specific disease level and patient-specific sociodemographic characteristics, suggesting that practitioners do influence receipt of these diagnostic services. These findings are consistent with the conclusion that practitioners act in response to a mix of patients' interests, economic selfinterests, and their own treatment preferences.

Practices participating in a dental PBRN have substantial and advantageous diversity even though as a group they have much in common with dentists at large

“…The results in this current paper take the next analytic step and indicate that practitioner-investigators participating in DPBRN vary substantially with regard to many characteristics, including practice setting, patient population, dental procedure characteristics, and dentist individual characteristics. Previous research has shown that dental practice characteristics are related to the diagnostic services [ 18 ], preventive procedures [ 19 ], and treatment procedures [ 20 , 21 ] that patients receive, as well as to their treatment outcomes [ 17 ]. Establishing a PBRN with a diverse range of these practice characteristics creates a research context ripe for relating these characteristics to treatment outcomes and to success in moving new knowledge into routine practice.…”

Diagnostic services in Australia: service rates and characteristics of patients

“…29 Receipt of diagnostic radiographs has also been related to a range of practice characteristics independently of patient disease levels and sociodemographics. 30 These findings were interpreted as an indication that providers can exert an influence on diagnostic service rates consistent with their acting in response to a consideration of interests of the patient, economic self-interest and their own preferences for treatment.…”

Patterns of postoperative pain medication prescribing after invasive dental procedures

“…Few studies in dentistry have focused on racial disparities. Those we identified reported that patients in practices with more African Americans received fewer dental diagnostic radiographs, 5 and that patients who were African Americans had higher odds of receiving tooth extractions and lower odds for conservative treatments, regardless of their socioeconomic status. 6 Despite the fact that postoperative pain is common in dental practice, 7,8 we are not aware of any study that has explored whether racial disparities in pain management have been reported in dental care.…”