Influences of market competition on dental care utilization under the global budget payment system.
OBJECTIVE
The degrees of market competition usually influence providers' behaviors. This study investigated the influence of medical market competition on the utilization of dental care under the global budget payment system. This study also examined the relative factors that influence the utilization of dental care.


METHODS
This study used the healthcare sub-regions (HCSRs) in the healthcare net as the observation units. The dataset was the National Health Insurance dental care claim data from 1999 to 2002. The degree of market competition of dental care was measured by the Herfindahl Index (HI). The influences of medical market competition on the utilization of dental care were analyzed by multiple linear regression analysis.


RESULTS
When the market had a higher degree of competition, people had a higher number of dental utilizations after controlling for the other variables. When market competition increased by 1%, annual expenditures and frequencies of dental care as well as frequencies of tooth-filling per person increased by 0.4%. Thirty-three percent of dental expenditures could be explained by increases in the degree of market competition. Females or highly educated people had a positive correlation with dental utilization. However, the agricultural population negatively correlated with dental utilization. Average household income had no significant relationship with the frequency of dental care but had a significant negative association with dental expenditures when dental care was covered by health insurance.


CONCLUSIONS
After the global budget payment system for dental care was implemented, increases in dental care market competition led to the increase in utilization of dental care services.
Tsai
Wen-Chen
WC
Department of Health Services Management, China Medical University, Taichung, Taiwan. wtsai@mail.cmu.edu.tw
Kung
Pei-Tseng
PT
Chang
Wei-Chieh
WC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002017:Budgets; D002648:Child; D002675:Child, Preschool; D003729:Dental Care / Q000706:statistics & numerical data*; D003815:Dentists / Q000600:supply & distribution*; D004465:Economic Competition; D018588:Fee-for-Service Plans; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007223:Infant; D007347:Insurance, Dental; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D012959:Socioeconomic Factors; D013624:Taiwan