A comparison of service profiles in alternative dental care delivery systems

The financial crisis within the health care sector has resulted in the search by medical benefit funds of worker organisations for cost-effective alternatives to the private health care sector. This study compares the profile of services rendered to members of a union medical benefit fund by an 'in house' dental clinic and private dental practitioners. A total of 2,858 union clinic claims and 10,811 private practitioner accounts were selected. Each treatment code was categorised into either preventive, restorative, extraction or denture services. For the union clinic and private dental practitioners a total of 3,021 and 15,853 treatment codes respectively were included in the analysis. Significant differences were found in the profile of services rendered by the union clinic and private dental practitioners. The union clinic provided predominantly preventive and denture-related treatment compared with private practitioners who provided mainly preventive and extraction services. Members and their dependants are far more likely to have dentures made through the dental clinic (the odds of having dentures made at the clinic were 4.67 times the odds of having dentures made through private practitioners). On the other hand, members were more likely to receive all the other services (restorative, preventive and extractions) from private practitioners. However, the nature of the study design and the findings do not allow conclusions to be drawn regarding whether these differences were due to demand or supplier influences.