Department of Community Dentistry, Dental Faculty University of Oslo, Oslo, Norway.
Department of Obstetrics and Gynecology, Institute of Clinical Medicine, Akershus University Hospital, Lørenskog, Norway.
Community Dent Oral Epidemiol. 2023 Oct;51(5):778-785. doi: 10.1111/cdoe.12750. Epub 2022 May 26.
In Norway, supply of dental services exceeds demand, mainly because of the marked improvement in dental health during the last few decades. The aim of the study was to investigate whether private dental practitioners counteract a fall in demand for their services by providing more services or by raising their fees.
The data were collected using a questionnaire that was sent to all private dental practitioners in Norway. Altogether 1237 practitioners responded, which gave a response rate of 56%. Our sample was representative of the population of practitioners in Norway. As a measure of patient supply, responses from the following questions were used: 'Based on an overall assessment of economy, workload and other personal factors, is the number of regular patients adequate? If not, do you wish to have more patients, or fewer patients?' The outcome variables were dental fees, length of recall interval and mean cost per visit. The data were analysed using ordinary least square regression and a linear probability model. The following characteristics of the private dental practitioners were included as control variables: age, gender, work experience in years and whether they worked in a solo practice. To test the robustness of the findings, a supplementary analysis with the patient as the unit of analysis was carried out, using survey data of Norwegians aged 20 years and older. Based on this survey, the relationship between population: dentist ratio and mean cost per dental visit were examined.
Nearly 40% of all practitioners reported that they had too few patients. They compensated for their loss of income by raising their fees, by recalling their patients more often and by increasing the cost per visit. The finding in the supplementary analysis using survey data from patients was similar to the findings in the main analyses using survey data from private dental practitioners.
The findings show that practitioners have market power. They were able to counteract a fall in demand for their services by providing more services and by raising their fees. The dental profession should be encouraged to provide appropriate services, in the present situation where supply exceeds demand.
在挪威，牙科服务的供应超过了需求，主要是因为在过去几十年中，牙科健康状况显著改善。本研究旨在调查私人牙医是否通过提供更多服务或提高费用来抵消服务需求下降的影响。
使用问卷收集数据，该问卷发送给挪威所有私人牙医。共有 1237 名从业者做出了回应，回应率为 56%。我们的样本代表了挪威牙医群体。作为患者供应的衡量标准，我们使用了以下问题的回答：“根据经济、工作量和其他个人因素的总体评估，您的常规患者数量是否充足？如果不足，您希望有更多的患者还是更少的患者？” 因变量为牙科费用、复诊间隔时间和每次就诊的平均费用。使用普通最小二乘回归和线性概率模型分析数据。将私人牙医的以下特征作为控制变量纳入分析：年龄、性别、工作年限以及是否单独执业。为了检验结果的稳健性，我们进行了一项补充分析，以患者为单位，使用挪威 20 岁及以上人群的调查数据。基于该调查，我们检验了人口：牙医比例与每次牙科就诊平均费用之间的关系。
近 40%的从业者报告称他们的患者太少。他们通过提高费用、更频繁地召回患者以及增加每次就诊的费用来弥补收入损失。使用患者调查数据进行的补充分析的结果与使用私人牙医调查数据进行的主要分析的结果相似。
研究结果表明，牙医具有市场力量。他们通过提供更多服务和提高费用来抵消服务需求下降的影响。在供应超过需求的现状下，应鼓励牙科行业提供适当的服务。
