The relationship between price of services, quality of care, and patient time costs for general dental practice.
OBJECTIVE
To examine the relationships between price of services, quality of care, and patient time costs in private practices of general dentists.


METHODS
In October 1992, a 3.7 percent sample of eligible general dentists in part-time or full-time private practice in 1991 was randomly drawn from a sampling frame tailored from data gathered by the 1991-1992 American Dental Association Distribution of Dentists census of all United States dentists.


METHODS
A mail survey was used to collect data on dentist demographic characteristics, dental practice characteristics practice finances, and insurance. The survey was completed and returned by 3,048 general dentists (77 percent response rate). Local area population characteristics were obtained from secondary sources.


METHODS
Two-stage least squares regression was used to evaluate the structural relationships between price of services, quality of care, and time costs to patients. Structural equations were estimated for four different quality of care measures and two time costs.


RESULTS
Price of services and quality of care were significantly related to each other. Higher quality of care was associated with higher price of services and, reciprocally, higher price of services was associated with higher quality of care. Shorter waits for a new patient appointment were associated with higher prices. Higher price of services, lower quality of care, and longer waits for a new patient appointment were related to shorter in-office waiting time.


CONCLUSIONS
The implication of these findings is that if price of services is constrained, then the quality of care provided by the dentist may also be reduced.
Whitney
C W
CW
Department of Dental Public Health Sciences, University of Washington, Seattle 98195-7475, USA.
Milgrom
P
P
Conrad
D
D
Fiset
L
L
O'Hara
D
D
D005250:Fees, Dental; D005792:General Practice, Dental / Q000191:economics* / Q000592:standards*; D006302:Health Services Research; D006801:Humans; D016018:Least-Squares Analysis; D011331:Private Practice / Q000191:economics* / Q000592:standards*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D014850:Waiting Lists