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

Area of Science:

• Dental Practice Management
• Health Services Research
• Health Economics

Background:

• Understanding factors influencing clinical decision-making is crucial for optimizing dental care delivery.
• Geographic distribution and market competition can significantly shape professional practices.

Purpose of the Study:

• To examine the relationship between dentist density, perceived market competition, and clinical decision-making among Ontario dentists.
• To assess how competitive pressures influence treatment intensity in a Canadian dental market.

Main Methods:

• Quantified competition using dentist density (clinics within a 1km radius) and self-reported competitive pressure.
• Measured clinical decision-making through standardized clinical scenarios, categorizing dentists as aggressive or conservative.
• Employed bivariate analysis and logistic/linear regression to assess associations.

Main Results:

• Dentists reporting high competitive pressure were more likely to exhibit aggressive treatment choices (OR = 1.63).
• Dentists in very low dentist density areas also demonstrated a tendency towards more aggressive treatment decisions (OR = 1.31).

Conclusions:

• This research is the first to investigate the impact of competition on dentist clinical decision-making in Canada.
• Findings highlight the influence of market dynamics on treatment intensity within the Canadian dental care sector.