title: Perspectives on providing good access to dental services for elderly people: patient selection, dentists' responsibility and budget management.
abstract: OBJECTIVE
  To suggest a model for organizing and financing dental services for elderly people so that they have good access to services.
  
  
  BACKGROUND
  There are few studies on how dental services for elderly people should be organized and financed. This is surprising if we take into consideration the fact that the proportion of elderly people is growing faster than any other group in the population, and that elderly people have more dental diseases and poorer access to dental services than the rest of the adult population. In several countries, dental services are characterized by private providers who often operate in a market with competition and free price-setting. Private dentists have no community responsibility, and they are free to choose which patients they treat.
  
  
  METHODS
  Literature review and critical reasoning.
  
  
  RESULTS
  In order to avoid patient selection, a patient list system for elderly people is recommended, with per capita remuneration for the patients that the dentist is given responsibility for. The patient list system means that the dentist assumes responsibility for a well-defined list of elderly people.
  
  
  CONCLUSIONS
  Our model will lead to greater security in the dentist/patient relationship, and patients with great treatment needs will be ensured access to dental services.
authors.affiliation: Institute of Community Dentistry, University of Oslo, N-0316 Oslo, Norway. josteing@odont.uio.no
authors.forename: Jostein
authors.initials: J
authors.lastname: Grytten
authors.forename: Dorthe
authors.initials: D
authors.lastname: Holst
mesh_terms: D000368:Aged; D002017:Budgets; D002204:Capitation Fee; D003363:Cost Control; D016321:Dental Care for Aged / Q000191:economics / Q000458:organization & administration; D003812:Dentist-Patient Relations; D003815:Dentists; D004465:Economic Competition; D005250:Fees, Dental; D005378:Financial Support; D005381:Financing, Organized; D017048:Health Care Costs; D019981:Health Care Sector; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D008962:Models, Theoretical; D009664:Norway; D018579:Patient Selection; D017149:Private Sector; D012051:Reimbursement Mechanisms; D012941:Social Responsibility