Effect of risk-based payment model on caries inequalities in preschool children assessed by geo-mapping
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Effect of risk-based payment model on caries inequalities in preschool children assessed by geo-mapping. / Holmén, Anders; Strömberg, Ulf; Håkansson, Gunnel; Twetman, Svante.
In: BMC Oral Health, Vol. 18, No. 1, 3, 2018, p. 1-8.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effect of risk-based payment model on caries inequalities in preschool children assessed by geo-mapping
AU - Holmén, Anders
AU - Strömberg, Ulf
AU - Håkansson, Gunnel
AU - Twetman, Svante
PY - 2018
Y1 - 2018
N2 - BACKGROUND: To describe, with aid of geo-mapping, the effects of a risk-based capitation model linked to caries-preventive guidelines on the polarization of caries in preschool children living in the Halland region of Sweden.METHODS: The new capitation model was implemented in 2013 in which more money was allocated to Public Dental Clinics surrounded by administrative parishes inhabited by children with increased caries risk, while a reduced capitation was allocated to those clinics with a low burden of high risk children. Regional geo-maps of caries risk based on caries prevalence, level of education and the families purchasing power were produced for 3-6-year-old children in 2010 (n = 10,583) and 2016 (n = 7574). Newly migrated children to the region (n = 344 in 2010 and n = 522 in 2016) were analyzed separately. A regional caries polarization index was calculated as the ratio between the maximum and minimum estimates of caries frequency on parish-level, based on a Bayesian hierarchical mapping model.RESULTS: Overall, the total caries prevalence (dmfs > 0) remained unchanged from 2010 (10.6%) to 2016 (10.5%). However, the polarization index decreased from 7.0 in 2010 to 5.6 in 2016. Newly arrived children born outside Sweden had around four times higher caries prevalence than their Swedish-born peers.CONCLUSIONS: A risk-based capitation model could reduce the socio-economic inequalities in dental caries among preschool children living in Sweden. Although updated evidence-based caries-preventive guidelines were released, the total prevalence of caries on dentin surface level was unaffected 4 years after the implementation.
AB - BACKGROUND: To describe, with aid of geo-mapping, the effects of a risk-based capitation model linked to caries-preventive guidelines on the polarization of caries in preschool children living in the Halland region of Sweden.METHODS: The new capitation model was implemented in 2013 in which more money was allocated to Public Dental Clinics surrounded by administrative parishes inhabited by children with increased caries risk, while a reduced capitation was allocated to those clinics with a low burden of high risk children. Regional geo-maps of caries risk based on caries prevalence, level of education and the families purchasing power were produced for 3-6-year-old children in 2010 (n = 10,583) and 2016 (n = 7574). Newly migrated children to the region (n = 344 in 2010 and n = 522 in 2016) were analyzed separately. A regional caries polarization index was calculated as the ratio between the maximum and minimum estimates of caries frequency on parish-level, based on a Bayesian hierarchical mapping model.RESULTS: Overall, the total caries prevalence (dmfs > 0) remained unchanged from 2010 (10.6%) to 2016 (10.5%). However, the polarization index decreased from 7.0 in 2010 to 5.6 in 2016. Newly arrived children born outside Sweden had around four times higher caries prevalence than their Swedish-born peers.CONCLUSIONS: A risk-based capitation model could reduce the socio-economic inequalities in dental caries among preschool children living in Sweden. Although updated evidence-based caries-preventive guidelines were released, the total prevalence of caries on dentin surface level was unaffected 4 years after the implementation.
KW - Capitation Fee/organization & administration
KW - Child
KW - Child, Preschool
KW - Dental Caries/epidemiology
KW - Female
KW - Geography, Medical
KW - Health Status Disparities
KW - Humans
KW - Male
KW - Models, Economic
KW - Risk Factors
KW - Sweden/epidemiology
U2 - 10.1186/s12903-017-0470-6
DO - 10.1186/s12903-017-0470-6
M3 - Journal article
C2 - 29304785
VL - 18
SP - 1
EP - 8
JO - BMC Oral Health
JF - BMC Oral Health
SN - 1472-6831
IS - 1
M1 - 3
ER -
ID: 202239885