title: Dental treatment injuries in the Finnish Patient Insurance Centre in 2000-2011.
abstract: Objective The Patient Insurance Centre in Finland reimburses patients who sustained injuries associated with medical and dental care without having to demonstrate malpractice. The aim was to analyse all dental injuries claimed through the Patient Insurance Centre over a 12-year period in order to identify factors affecting reimbursement of claims. Methods This study investigated all dental patient insurance claims in Finland during 2000-2011. The injury cases were grouped as (K00-K08) according to the International Classification of Diseases (ICD-10). Calendar year, claimant's age and gender, dental disease group and health service sector were the explanatory factors and the outcome was the decision of a claim. Multiple logistic regression modelling was used in the statistical analyses. Results The total number of decisions related to dental claims at the PIC in 2000-2011 was 7662, of which women claimed a clear majority (72%). Diseases of the pulp and periapical tissues (K04) and dental caries (K02) were the major disease groups (both 29%). Of the claims 40% were eligible for reimbursement, 27% were classified as insignificant or unavoidable injuries and 32% were rejected for other reasons. The proportion of reimbursed claims declined during the period. Patients from the private sector were more likely to be eligible for compensation than were those from the public sector (OR = 1.89, 95% CI = 1.71-2.10). Conclusions The number of dental patient insurance claims in Finland clearly rose, while the proportion of reimbursed claims declined. More claims received compensation in the private sector than in the public sector.
authors.affiliation: a Department of Community Dentistry , Faculty of Medicine, University of Oulu , Oulu , Finland ;|b Medical Research Center Oulu, Oulu University Hospital , Oulu , Finland.
authors.forename: Sini
authors.initials: S
authors.lastname: Karhunen
authors.affiliation: a Department of Community Dentistry , Faculty of Medicine, University of Oulu , Oulu , Finland ;|b Medical Research Center Oulu, Oulu University Hospital , Oulu , Finland.
authors.forename: Jorma I
authors.initials: JI
authors.lastname: Virtanen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003729:Dental Care / Q000009:adverse effects* / Q000191:economics; D003731:Dental Caries / Q000191:economics; D003788:Dental Pulp Diseases / Q000191:economics; D005260:Female; D005387:Finland; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007344:Insurance Claim Reporting / Q000191:economics* / Q000706:statistics & numerical data; D007347:Insurance, Dental / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010483:Periapical Diseases / Q000191:economics; D017149:Private Sector / Q000191:economics / Q000706:statistics & numerical data; D017150:Public Sector / Q000191:economics / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms / Q000191:economics / Q000706:statistics & numerical data; D012737:Sex Factors; D016388:Tooth Loss / Q000191:economics; D055815:Young Adult
keywords: Dental claims; injury; insurance; patients; treatment