Practice characteristics associated with patient-specific receipt of dental diagnostic radiographs.
OBJECTIVE
To quantify the role of practice characteristics in patient-specific receipt of dental diagnostic radiographic services.


METHODS
Florida Dental Care Study (FDCS). Study Design. The FDCS was a 48-month prospective observational cohort study of community-dwelling adults. Participants' dentists were asked to complete a questionnaire about their practice characteristics.


METHODS
In-person interviews and clinical examinations were conducted at baseline, 24, and 48 months, with 6-monthly telephone interviews in between. A single multivariate (four radiographic service outcomes) multivariable (multiple explanatory covariates) logistic regression was used to model service receipts.


RESULTS
These practice characteristics were significantly associated with patient-specific receipt of radiographic services: number of different practices attended during follow-up; dentist's rating of how busy the practice was; typical waiting time for a new patient examination; practice size; percentage of patients that the dentist reported as interested in details about the condition of their mouths; percentage of African American patients in the practice; percentage of patients in the practice who do not have dental insurance; and dentist's agreement with a statement regarding whether patients should be dismissed from the practice. Effects had differential magnitudes and directions of effect, depending upon radiograph type.


CONCLUSIONS
Practice characteristics were significantly associated with patient-specific receipt of services. These effects were independent of patient-specific disease level and patient-specific sociodemographic characteristics, suggesting that practitioners do influence receipt of these diagnostic services. These findings are consistent with the conclusion that practitioners act in response to a mix of patients' interests, economic self-interests, and their own treatment preferences.
Gilbert
Gregg H
GH
Department of Diagnostic Sciences, UAB School of Dentistry, SDB Room 109, 1530 3rd Avenue South, Birmingham, AL 35294-0007, USA.
Weems
Richard A
RA
Litaker
Mark S
MS
Shelton
Brent J
BJ
D000328:Adult; D000368:Aged; D006801:Humans; D019458:Insurance Coverage; D008875:Middle Aged; D019239:Practice Patterns, Dentists'; D011364:Professional Practice / Q000458:organization & administration*; D011446:Prospective Studies; D011861:Radiography, Dental / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D016526:Workload