A longitudinal study of young Finnish adults' use of subsidized, private sector dental care, 1986-1997.
OBJECTIVE
Finns born after 1956 are now entitled to subsidized private sector dental care, or such persons could be enrolled in the Public Dental Service. Until 1986, eligibility was more restrictive. The purpose of this study was to investigate the use and costs of private dental care and effects of regularity of care on costs and treatment received among young Finnish adults during 1986-1997.


METHODS
All 1986, 1990 and 1994 recipients of reimbursement for dental care from the Social Insurance Institution were included in the study. Five separate age cohorts were compared. Using their civil registration numbers, individuals were tracked from their first contact with a private dentist in one of the years 1986, 1990 or 1994 until the year 1997.


RESULTS
While the total number of young adults who had received reimbursement for private dental care increased from about 53000 (1986) to 200000 (1994) due to extended eligibility, the number of users in the youngest group decreased from 53000 to 23000. Attending infrequently (1-2 times during the study period) was most common among the youngest adults and frequent attendance (annually) was most common among older adults. The annual mean cost was slightly lower among the frequent attenders in almost every cohort. Variation in the mean number of annual visits was directly correlated with costs. Frequent attenders most often received diagnostic and preventive measures while restorations and surgery were most common for the infrequent attenders.


CONCLUSIONS
A substantial decline in the demand for private services among the 19-25-year-olds and stable demand among 26-34-year-olds was detected, indicating falling treatment needs or a preference for the Public Dental Service. All groups had a stable mean number of visits per year and almost constant costs. The mean number of dental visits per year remained steady in all cohorts indicating rigid treatment patterns.
Suominen-Taipale
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The National Research and Development Centre for Welfare and Health, Helsinki, Finland. liisa.suominen-taipale@medisin-ntnu.no
Widström
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E
D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003729:Dental Care / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland; D017048:Health Care Costs; D019456:Health Transition; D006801:Humans; D007347:Insurance, Dental; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data; D016018:Least-Squares Analysis; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D017149:Private Sector / Q000191:economics / Q000706:statistics & numerical data*