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.
Locker
D
D
Community Dental Health Services Research Unit, Faculty of Dentistry, University of Toronto, Ontario, Canada. dlocker@dental.utoronto.ca
Clarke
M
M
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