An assessment of capitation in the General Dental Service contract 2. Patterns of treatment provided to regularly attending patients.
OBJECTIVE
To compare the patterns of treatment of general dental practitioners working under fee-for-service in 1987/88 with those working under capitation in 1992/93.


METHODS
73 randomly selected general dental practitioners working under capitation in three contrasting areas in England retrospectively recorded the treatment provided during 1992/93 to a random selection of their regularly attending 6-12- and 14-15-year-old patients.


RESULTS
Mean numbers of examinations per year reduced in the three areas from 1.7-1.8 in 1987/88 to 1.2-1.4 in 1992/93. Mean numbers of visits per patient dropped from 2.5-2.9 to 1.8-2.2. Mean numbers of fillings in permanent teeth reduced from 0.15-1.04 to 0.09-0.52 and in deciduous teeth from 0.28-0.53 to 0.24-0.31. Mean percentages of children per dentist having extractions fell from 9.3-28.1% to 4.7-16.2% while the radiographs reduced from 14.0-9.0% to 6.0-10.6%. Mean percentages of children per dentist receiving oral hygiene instruction rose from 18-31% in 1987/88 to 26-33% in 1992/93. Dietary advice increased from 3-18% to 11-20% and fissure sealants from 3-6% to 3-12%.


CONCLUSIONS
In 1992/93, dentists working under capitation were carrying out fewer examinations, fillings and extractions and were taking fewer radiographs for their regularly attending child and adolescent patients than dentists working under fee-for-service in 1987/88. These patients also attended less frequently for treatment but received marginally more preventive care and advice.
Mellor
A C
AC
University Dental Hospital of Manchester.
Blinkhorn
A S
AS
Hassall
D C
DC
Holloway
P J
PJ
Worthington
H V
HV
D000293:Adolescent; D002204:Capitation Fee; D002648:Child; D003729:Dental Care / Q000191:economics* / Q000706:statistics & numerical data; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D004032:Diet; D004739:England / Q000453:epidemiology; D005250:Fees, Dental; D005792:General Practice, Dental / Q000706:statistics & numerical data; D006267:Health Education, Dental / Q000706:statistics & numerical data; D006801:Humans; D052756:Nutritional Sciences / Q000193:education; D009910:Oral Hygiene / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011861:Radiography, Dental / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013222:State Medicine / Q000191:economics*; D014081:Tooth Extraction / Q000706:statistics & numerical data; D014094:Tooth, Deciduous
D010895:Pit and Fissure Sealants