Grembowski D, Conrad D A
Soc Sci Med. 1986;23(11):1131-8. doi: 10.1016/0277-9536(86)90330-8.
For many Americans the cost of dental services represents a barrier to receiving regular dental care and maintaining proper oral health. The recent growth of the dental insurance industry, however, may partly offset this price barrier among insureds. Our purpose is to examine the relationship between coinsurance and dental prices for 16 dental services among a sample of Pennsylvania Blue Shield (PBS) adult insureds. The dependent price measure is the annual average gross price paid for 16 specific preventive, restorative, periodontic, endodontic, prosthodontic, and surgical dental services. Independent variables in the price model include the insured's age, education, coinsurance rates, time costs, market area, non-wage income, oral health status, area dentist-population ratio and usual source of care. Data sources are 1980 PBS claims and coinsurance rate data and a mail survey of sampled insureds. OLS regression analysis reveals that the model's independent variables explain little dental price variation. No variable is consistently significant across services, but market area, coinsurance rates, and time costs alternately dominate across equations. These results suggest that, among adult insureds, coinsurance and time costs influence dental fees in a minority of dental services. Insurance reduces the patient's sensitivity to money price, and non-price factors correspondingly seem to become more important in patient search.
对许多美国人来说,牙科服务费用是获得常规牙科护理和保持口腔健康的一大障碍。然而,牙科保险行业最近的发展可能会部分抵消被保险人面临的这一价格障碍。我们的目的是研究宾夕法尼亚蓝盾(PBS)成年被保险人样本中16种牙科服务的共保率与牙科价格之间的关系。因变量价格指标是为16种特定的预防性、修复性、牙周病、牙髓病、口腔修复和外科牙科服务支付的年度平均总价。价格模型中的自变量包括被保险人的年龄、教育程度、共保率、时间成本、市场区域、非工资收入、口腔健康状况、地区牙医与人口比例以及通常的医疗服务来源。数据来源是1980年PBS的理赔和共保率数据以及对抽样被保险人的邮件调查。普通最小二乘法回归分析表明,该模型的自变量对牙科价格变化的解释力很小。没有一个变量在所有服务中都始终具有显著性,但市场区域、共保率和时间成本在不同方程中交替占据主导地位。这些结果表明,在成年被保险人中,共保率和时间成本仅在少数牙科服务中影响牙科费用。保险降低了患者对货币价格的敏感度,相应地,非价格因素在患者寻找医疗服务时似乎变得更加重要。