Pulsipher C, BeGole E A, Rauschenberger C
Department of Orthodontics, University of Illinois at Chicago, USA.
J Endod. 2000 Oct;26(10):610-4. doi: 10.1097/00004770-200010000-00008.
A survey was published in the Quarterly Survey of Dental Practice (QSDP) Special Topics that dealt with contractual agreements in dentistry. This survey evaluated general dental practitioner participation apart from that of dental specialists in general. The Quarterly Survey of Dental Practice survey was modified and used in the present study to specifically determine the participation by endodontists in various contractual insurance agreements, including Preferred Provider Organization and Health Maintenance Organization programs. A 10% sample of practicing endodontists was randomly selected to participate in this survey. Questionnaires (331) were sent out, and 229 or 69% were returned. Total participation by endodontists responding to this survey in any Health Maintenance Organization and/or Preferred Provider Organization insurance plans was 31.3%; however the total percentage of patients treated under these insurance plans was only 6.6%. These results were similar to those in the 1994 survey in which it was shown that 27% of the general dental practitioners and 41% of the dental specialists participated in one or more of these insurance programs and treated respectively, 5% and 9%, of their patients under these plans. Although participation in various managed care programs by endodontists in this survey was close to one-third, the total number of patients treated under these plans was low. Overall patients treated under fee-for-service arrangements by endodontists responding to this survey formed 85.3% of their patient pool. It does not appear from the results of this survey that managed care insurance has a significant impact on the practice of endodontics. It can be postulated that endodontists are unwilling to accept more than a small reduction in fees to join managed care plans, and they also desire to retain full control of their dental practice.
一项关于牙科合同协议的调查发表在《牙科实践季刊调查》（QSDP）专题中。该调查评估了普通牙科从业者的参与情况，总体上不包括牙科专科医生。《牙科实践季刊调查》在本研究中经过修改，专门用于确定牙髓病医生参与各种合同保险协议的情况，包括优先提供者组织和健康维护组织计划。随机抽取了10%的执业牙髓病医生样本参与此次调查。共发放问卷331份，回收229份，回收率为69%。参与此次调查的牙髓病医生在任何健康维护组织和/或优先提供者组织保险计划中的总体参与率为31.3%；然而，在这些保险计划下接受治疗的患者总数仅占6.6%。这些结果与1994年的调查结果相似，当时的调查显示，27%的普通牙科从业者和41%的牙科专科医生参与了这些保险计划中的一项或多项，并分别在这些计划下治疗了其5%和9%的患者。尽管在此次调查中牙髓病医生参与各种管理式医疗计划的比例接近三分之一，但在这些计划下接受治疗的患者总数却很低。参与此次调查的牙髓病医生按服务收费安排治疗的患者在其患者群体中占85.3%。从此次调查结果来看，管理式医疗保险似乎对牙髓病治疗实践没有重大影响。可以推测，牙髓病医生不愿意为加入管理式医疗计划而接受大幅降低费用，并且他们也希望完全掌控自己的牙科业务。
