title: Reimbursement systems influence prosthodontic treatment of adult patients.
abstract: OBJECTIVE
  To evaluate the influence of reimbursement system and organizational structure on oral rehabilitation of adult patients with tooth loss.
  
  
  METHODS
  Patient data were retrieved from the databases of the Swedish Social Insurance Agency. The data consisted of treatment records of patients aged 19 years and above claiming reimbursement for dental care from July 1, 2007 until June 30, 2009. Before July 1, 2008, a proportionately higher level of subsidy was available for dental care in patients 65 years and above, but thereafter the system was changed, so that the subsidy was the same, regardless of the patient's age. Prosthodontic treatment in patients 65 years and above was compared with that in younger patients before and after the change of the reimbursement system. Prosthodontic treatment carried out in the Public Dental Health Service and the private sector was also analyzed.
  
  
  RESULTS
  Data were retrieved for 722,842 adult patients, covering a total of 1,339,915 reimbursed treatment items. After the change of the reimbursement system, there was a decrease in the proportion of items in patients 65 years and above in relation to those under 65. Overall, there was a minimal change in the proportion of treatment items provided by the private sector compared to the public sector following the change of the reimbursement system.
  
  
  CONCLUSIONS
  Irrespective of service provider, private or public, financial incentive such as the reimbursement system may influence the provision of prosthodontic treatment, in terms of volume of treatment.
authors: The Swedish Council on Health Technology Assessment , Stockholm , Sweden.
authors: Thomas
authors: T
authors: Davidson
authors: Madeleine
authors: M
authors: Rohlin
authors: Margareta
authors: M
authors: Hultin
authors: Torsten
authors: T
authors: Jemt
authors: Krister
authors: K
authors: Nilner
authors: Karin
authors: K
authors: Sunnegårdh-Grönberg
authors: Sofia
authors: S
authors: Tranæus
authors: Mats
authors: M
authors: Nilsson
mesh_terms: D000328:Adult; D000368:Aged; D003442:Crowns / Q000191:economics; D015921:Dental Implants / Q000191:economics; D017266:Dental Prosthesis; D019094:Dental Prosthesis, Implant-Supported / Q000191:economics; D003824:Denture, Complete / Q000191:economics; D003828:Denture, Overlay / Q000191:economics; D003830:Denture, Partial, Fixed / Q000191:economics; D003832:Denture, Partial, Removable / Q000191:economics; D005260:Female; D005380:Financing, Government; D006801:Humans; D008297:Male; D008875:Middle Aged; D011331:Private Practice; D011636:Public Health Dentistry; D012051:Reimbursement Mechanisms; D012052:Reimbursement, Incentive; D013218:State Dentistry; D013548:Sweden; D016388:Tooth Loss / Q000191:economics / Q000628:therapy*; D055815:Young Adult
chemical_list: D015921:Dental Implants
keywords: financial incentives; insurance; prosthodontics