Holloway P J, Lennon M A, Mellor A C, Coventry P, Worthington H V
Department of Oral Health and Development, University Dental Hospital of Manchester.
Br Dent J. 1990 Feb 10;168(3):119-21. doi: 10.1038/sj.bdj.4807099.
Four matched pairs of geographically and socially contrasting areas of Britain were randomly allocated within pairs to either a capitation or fee-for-service payment system for the dental care of children in a 3-year clinical trial. Measurements were made on the dental health of randomly selected 5-6 and 14-15-year-old patients and the views of their parents elicited. Patterns of treatment were also gained from the clinical records of randomly selected patients. In addition, the views of the dentists taking part, of the profession's representatives, and of the administrators of the systems were obtained. No evidence of systematic neglect could be found among the children treated under capitation, but they had fewer fillings, more untreated diseased teeth and similar disease levels to their counterparts treated under fee-for-service. Dentists in capitation carried out fewer fillings, fewer extractions, took fewer radiographs and saw their patients less frequently than their fee-for-service colleagues.
在一项为期3年的临床试验中，英国四对在地理和社会方面形成对比的地区被随机配对，每对中的一个地区采用人头付费制，另一个地区采用按服务收费制来为儿童提供牙科护理。对随机抽取的5至6岁和14至15岁患者的牙齿健康状况进行了测量，并征求了他们父母的意见。还从随机抽取患者的临床记录中了解了治疗模式。此外，还获取了参与试验的牙医、行业代表以及该系统管理人员的意见。在接受人头付费制治疗的儿童中，未发现系统性忽视的证据，但与接受按服务收费制治疗的儿童相比，他们补牙的数量更少，未治疗的患牙更多，疾病水平相似。与按服务收费制的同行相比，采用人头付费制的牙医补牙和拔牙的数量更少，拍X光片的次数更少，看诊患者的频率也更低。
