Eight years ago, prepaid dental care, Frisktandvård, was introduced as a new method of payment within the Swedish Public Dental Service. A thesis that has carried out an assessment of this reform shows that patients in Frisktandvård experienced better control over both their dental health and money – and also got less caries over time.
Frisktandvård was introduced in 2007, partly as a way of encouraging more people, primarily the young, to continue to go for regular dental check-ups. A thesis by Charlotte Andrén Andås, a doctoral student atSahlgrenskaAcademy,UniversityofGothenburg, has now investigated some of the effects of the reform in the Region Västra Götaland.
The study, which looked at over 6,000 individuals, shows that those who chose Frisktandvård from the start in 2007 were generally more motivated and interested in health-promoting behaviours –and are at less risk of developing caries.
Since the introduction of the new payment model, patients paying the traditional way have had a 50 per cent higher risk of developing caries than those who paid according to the Frisktandvård model.
“This difference persisted still after taking into account other potential influencing factors for the development of caries, such as age, gender, level of education and the individuals’ amount of caries before the option to sign a contract existed,” said Charlotte Andrén Andås.
More preventative treatment
According to her thesis, patients with Frisktandvård contracts received more preventative treatment as compared to patients in the traditional fee-for-service payment model. In addition, Frisktandvård patients were more likely to regard their oral health as very important for their wellbeing than patients who paid according to the traditional model.
“A number of patients called for better information about what they were actually bound to by the contract. But on the whole, Frisktandvård patients are very satisfied with the model. Over 91 per cent like the model,” said Andås.
Assurance and control
The results of the thesis show that patients with Frisktandvård contracts experience feelings of assurance and control regarding both their dental care and its consequences for their household economy.
“Having more say in one’s own treatment may lead to a better understanding of how important it is to take personal responsibility for one’s own dental health. A mutual agreement seems to have a positive impact both on dental health behaviours and dental health,” said Andås.
Andås will publicly defend her thesis A New Payment Model in Swedish Dental Care on 27 November. – Krister Svahn
(Photo Credits: The Swedish Public Dental Service, Västra Götaland Region)