Geographic variations in dental services provided to older adults in Ontario, Canada.
In an initial study, Leake et al. (J Public Health Dent 1996; 52: 182-90) found that older Ontarians living in metropolitan communities received almost twice the amount of dental care than older Ontarians living in non-metropolitan communities. Since data were collected for the 2 years prior to the enrollment of subjects in a longitudinal study, factors responsible for this variation could not be explored. This paper extends these findings by examining the volume of dental services received by these subjects in the 3 years between the baseline and follow-up phases of the longitudinal study. During this 3-year period, geographic variations in the volume of services provided were also observed. In a regression analysis, geographic location remained a significant predictor of the number of services received after controlling for six other explanatory variables: insurance coverage, number of teeth, restorative treatment need, self-rated oral health, regular dental visits and use of specialist services. Together, these explained only 24% of the variance in service provision. Since patient-reported outcomes were better in the communities with higher volumes of provision, further research concerning the patient and dentist factors influencing treatment provision is warranted.
Community Dental Health Services Research Unit, Faculty of Dentistry, University of Toronto, Ontario, Canada. dlocker@dental.utoronto.ca
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D000368:Aged; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D016321:Dental Care for Aged / Q000706:statistics & numerical data; D003752:Dental Health Services / Q000706:statistics & numerical data / Q000600:supply & distribution*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario; D011897:Random Allocation; D016896:Treatment Outcome