Oral Health Care Reform in Finland – aiming to reduce inequity in care provision
Permanent lenke
https://hdl.handle.net/10037/1887Dato
2008-01-28Type
Journal articleTidsskriftartikkel
Peer reviewed
Sammendrag
Background: In Finland, dental services are provided by a public (PDS) and a private sector. In the past,
children, young adults and special needs groups were entitled to care and treatment from the public dental
services (PDS). A major reform in 2001 – 2002 opened the PDS and extended subsidies for private dental
services to all adults. It aimed to increase equity by improving adults' access to oral health care and
reducing cost barriers. The aim of this study was to assess the impacts of the reform on the utilization of
publicly funded and private dental services, numbers and distribution of personnel and costs in 2000 and
in 2004, before and after the oral health care reform. An evaluation was made of how the health political
goals of the reform: integrating oral health care into general health care, improving adults' access to care
and lowering cost barriers had been fulfilled during the study period.
Methods: National registers were used as data sources for the study. Use of dental services, personnel
resources and costs in 2000 (before the reform) and in 2004 (after the reform) were compared.
Results: In 2000, when access to publicly subsidised dental services was restricted to those born in 1956
or later, every third adult used the PDS or subsidised private services. By 2004, when subsidies had been
extended to the whole adult population, this increased to almost every second adult. The PDS reported
having seen 118 076 more adult patients in 2004 than in 2000. The private sector had the same number
of patients but 542 656 of them had not previously been entitled to partial reimbursement of fees.
The use of both public and subsidised private services increased most in big cities and urban municipalities
where access to the PDS had been poor and the number of private practitioners was high. The PDS
employed more dentists (6.5%) and the number of private practitioners fell by 6.9%. The total dental care
expenditure (PDS plus private) increased by 21% during the study period. Private patients who had
previously not been entitled to reimbursements seemed to gain most from the reform.
Conclusion: The results of this study indicate that implementation of a substantial reform, that changes
the traditionally defined tasks of the public and private sectors in an established oral health care provision
system, proceeds slowly, is expensive and probably requires more stringent steering than was the case in
Finland 2001 – 2004. However, the equity and fairness of the oral health care provision system improved
and access to services and cost-sharing improved slightly.
Forlag
BioMed CentralSitering
BMC Oral Health 2008, 8:3 doi:10.1186/1472-6831-8-3Metadata
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