Andås C A, Hakeberg M
Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Community Dent Health. 2016 Dec;33(4):257-261. doi: 10.1922/CDH_3843Andas05.
The aim of this longitudinal study of patients in regular dental care was to compare the findings of manifest caries and fillings after a 6-year adherence to either of two optional payment models, the traditional fee-for service (FFS) model, or the new capitation model 'Dental Care for Health' (DCH).
Data on manifest caries lesions, the number of fillings and a number of background variables were collected from both a register and a questionnaire completed by 6,299 regular dental patients who met the inclusion criteria. The influence of payment system adherence and background variables on the number of manifest caries lesions at study end was examined by the means of negative binomial regression analysis.
The incidence rate ratio of manifest caries lesions after six years in FFS was 1.5 compared to DCH, after controlling for age, gender, education and pre-baseline caries incidence. The number of fillings was higher in FFS than in DCH at study start and at study end, and was also described by a steeper slope.
At group level, this study showed a statistically significant difference between the caries situation after six years in DCH compared with FFS, when some important background factors, including pre-baseline caries, were kept constant in a regression model.
这项针对接受常规牙科护理患者的纵向研究旨在比较在六年内坚持两种可选付费模式（传统的按服务收费（FFS）模式或新的人头费模式“健康牙科护理”（DCH））之一后，明显龋齿和补牙的情况。
从登记册和一份由6299名符合纳入标准的常规牙科患者填写的问卷中收集了明显龋损、补牙数量以及一些背景变量的数据。通过负二项回归分析检验付费系统依从性和背景变量对研究结束时明显龋损数量的影响。
在控制了年龄、性别、教育程度和基线前龋齿发病率后，FFS模式下六年内明显龋损的发病率比与DCH模式相比为1.5。在研究开始和结束时，FFS模式下的补牙数量均高于DCH模式，且其增长斜率也更大。
在组水平上，当在回归模型中保持一些重要背景因素（包括基线前龋齿）不变时，本研究显示DCH模式下六年后的龋齿情况与FFS模式相比存在统计学上的显著差异。
