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Effects of provider incentives on dental X-raying in NHS Scotland: what happens if patients switch providers?
- Source :
-
The European journal of health economics : HEPAC : health economics in prevention and care [Eur J Health Econ] 2022 Feb; Vol. 23 (1), pp. 59-65. Date of Electronic Publication: 2021 Jul 13. - Publication Year :
- 2022
-
Abstract
- Background: In many market settings individuals are encouraged to switch health care providers as a means of ensuring more competition. Switching may have a potentially undesirable side effect of increasing unnecessary treatment. Focusing on the most common source of medical radiation (dental X-rays), the purpose of this study was to assess whether, upon switching dentist, X-ray exposure increases depending on the type of provider payment.<br />Methods: The analysis used longitudinal data from 2005 to 2016 covering a 5% random sample of the Scottish adult population covered by the National Health Service (NHS). Multiple fixed-effects panel regression analyses were employed to determine the correlation of provider remuneration with patients' likelihood of receiving an X-ray upon switching to a new dentist other things equal. A broad set of covariates including a patient's copayment status was controlled for.<br />Results: Upon switching to a dentist who was paid fee-for-service, patients had a by 9.6%-points (95% CI 7.4-11.8%) higher probability of receiving an X-ray, compared to switching to a salaried dentist. Results were robust when accounting for patient exemption status, as well as unobserved patient and dentist characteristics.<br />Conclusions: In comparison to staying with the same dentist, patients may be exposed to substantially more X-rays upon switching to a dentist who is paid fee-for-service. There may need to be better guidance and regulation to protect the health of those who have to switch provider due to moving and greater caution in advocating voluntary switching.<br /> (© 2021. The Author(s).)
- Subjects :
- Adult
Fee-for-Service Plans
Humans
Scotland
X-Rays
Motivation
State Medicine
Subjects
Details
- Language :
- English
- ISSN :
- 1618-7601
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The European journal of health economics : HEPAC : health economics in prevention and care
- Publication Type :
- Academic Journal
- Accession number :
- 34255240
- Full Text :
- https://doi.org/10.1007/s10198-021-01348-3