Public preferences for seeking publicly financed dental care and professional preferences for structuring it
Public preferences for seeking publicly financed dental care and professional preferences for structuring it
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DOI：
10.1111/j.1600-0528.2010.00534.x
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发表时间：
2010-04-10
影响因子：
2.3
通讯作者：
Locker, David
中科院分区：
文献类型：
--
作者：
Quinonez, Carlos;Figueiredo, Rafael;Locker, David
目的：检验以下假设：社会边缘化的加拿大人更有可能更喜欢在公共场所而不是私人环境中寻求牙科护理，并且加拿大牙医更有可能更喜欢类似于私人保险流程的公共牙科护理计划。方法：通过基于随机数字拨号和电话访谈技术的每周全国综合调查收集公众意见数据（n = 1005，> 18 年）。专业意见数据是通过对随机选择的加拿大牙医进行的全国邮寄调查收集的（n = 2219，回复率 = 45.8%）。为公众收集牙科和社会人口统计数据，以及牙医的专业人口统计数据。进行了描述性和基本回归分析。结果：大多数接受调查的加拿大人（66.4％）更喜欢在私人环境中寻求牙科护理，19％在社区诊所，7.6％在牙科学校；那些年轻且收入最低的人最有可能更喜欢在公共场所寻求牙科护理。大多数加拿大牙医（80.9%）认为政府应该参与牙科护理，但只有 46% 的人认为这一角色应该包括直接提供服务。三分之一的牙医还减少了执业中公共保险患者的数量。加拿大牙医更有可能更喜欢那些最能反映私人保险机制的公共计划。结论：最需要政府参与的人群的偏好与加拿大当前的融资和提供牙科护理的机制之间似乎存在政策脱节。由于几乎完全专注于第三方融资和间接交付，公共牙科保健政策可能无法充分满足最需要的人的需求，特别是在牙医对公共计划基本上不满意的环境下。
Objectives:To test the hypotheses that socially marginalised Canadians are more likely to prefer seeking dental care in a public rather than private setting, and that Canadian dentists are more likely to prefer public dental care plans that approximate private insurance processes.Methods:Data on public opinion were collected through a weekly national omnibus survey based on random digit dialling and telephone interview technology (n = 1005, > 18 years). Data on professional opinion were collected through a national mail-out survey of a random selection of Canadian dentists (n = 2219, response rate = 45.8%). Dental and socio-demographic data were collected for the public, as were professional demographic data for dentists. Descriptive and basic regression analyses were undertaken.Results:The majority of Canadians surveyed, 66.4%, prefer to seek dental care in a private setting, 19% in a community clinic, and 7.6% in a dental school; those that are younger and of lowest incomes are most likely to prefer seeking dental care in a public setting. Most Canadian dentists, 80.9%, believe that governments should be involved in dental care, yet only 46% believe this role should include direct delivery. A third of dentists have also reduced the amount of publicly insured patients in their practice. Canadian dentists are more likely to prefer those public plans that most closely reflect private insurance mechanisms.Conclusion:There appears to be a policy disconnect between the preferences of those populations where governmental involvement is most warranted, and the current mechanisms for financing and delivering dental care in Canada. By concentrating almost exclusively on third-party-type financing and indirect delivery, public dental care policy may not be adequately responding to those most in need, especially in an environment where dentists are largely dissatisfied with public plans.