(1) Health Service Executive, Sligo, Ireland
(2) Centre for Policy Studies, University College Cork, Republic of Ireland
(3) Universityof Leeds School of Dentistry, Leeds LS2 9JT, UK
* Corresponding author Email: n.woods@ucc.ie
Introduction
The aim of this study was to investigate whether the provision of dental services is influenced by economic incentives in a third-party funded dental service in the Republic of Ireland.
Materials and methods
Four treatment items were identified as outcome variables: extra-oral radiographs, endodontics, prolonged periodontal treatment and surgical extractions. These items were characterised by variation in regulation among administrative regions or variation in regulation over time. Claims data were obtained from the Primary Care Reimbursement Service, formerly known as the General Medical Services Payments Board. Population data were obtained from the Central Statistics Office. Data were obtained from the Principal Dental Surgeons in Ireland who apply local regulatory or price controls for certain items of treatment. The data were analysed to determine the impact of the variation in regulatory approach on claims data among the eight regional health administrative areas while controlling for known clinical or population structural factors.
Results
There was a substantially lower than average provision of extra-oral radiographs in regions where regulation was stringently applied. The provision of prolonged periodontal treatment was positively correlated with price. The dentist-to-population ratio is positively correlated with claims for surgical extractions.
Conclusion
There is evidence from within the funding system that economic incentives, arising from either the contract itself or due to the geographical structure of the dentist workforce in Ireland, lead to variations in certain items of service provision which are potentially inefficient and independent of known treatment need.
