Categorisation of dental care provided in the Netherlands

To describe the dental care provided in the Netherlands and investigate to what extent variations can be explained in accordance with certain general characteristics of patients.

Besides the more usual classification of treatment into groups of dental procedures, in this study it is done using constructed categorisation of dental care based on characteristics such as 'preventive', 'curative', 'new', 'time-consuming', 'complicated' and 'lucrative' treatment. The data were collected from various groups of dentists. Two smaller groups of dentists-informants were asked to categorise dental procedures: 16 out of 55 (29%) and 57 out of 150 (38%). Finally this resulted in six type-scores for each procedure. From another larger group of dentists (n = 607) data were collected about the procedures they performed on a 25% random sample of their patients. Categorisations of dental care per patient were calculated by combining the data on the factual procedures performed with the six 'type-scores' for the procedures concerned. Furthermore, the financial returns dentists generated per patient were calculated from the care they provided.

Multilevel analysis shows that considerable variation exists in the categorisations of dental care provided according to age, gender, insurance situation and income level of patients. In youths, for example, relatively more 'preventive' and less 'curative', 'complicated' and 'lucrative' treatment is done and 'older' adults receive relatively less 'preventive' and more 'curative', 'time-consuming' and 'complicated' treatment.

By classifying the dental care provided in certain categories, a general view is obtained of the variations between patients in the care provided. The age of patients appears to be the most critical factor, but there are differences among dentists in the way the age of patients influences their conduct in the provision of dental care.