The Effects of Managed Care on the Quality of Dental Hygiene Care
Managed care has become a prominent mechanism for insuring dental care. Empirical research suggests that managed dental plans provide lower quality care to patients. However, few studies have specifically addressed the effects of managed care on the quality of dental hygiene care. Thus, in this study the researcher examines whether dental hygienists deliver a lower level of treatment to managed care patients than to those who are not subject to managed care. Questionnaire data were gathered from 193 members of the American Dental Hygienists' Association residing in the Chicago area. The primary independent variable, managed care, was measured with an item that asked the respondents to indicate the percentage of patients they treat that are insured by a managed dental plan. The questionnaire also contained items that measured the frequency in which the respondents perform 23 tasks that are indicators of quality of dental hygiene care. Principal components factor analysis of these 23 items yielded the study's two dependent variables: periodontal procedures and appointment time. Regression analysis of the data revealed a significant negative relationship between managed care and appointment time. This relationship may be attributable to an economic incentive on the part of dentist-employers who control the amount of time scheduled for dental hygienists' patients. Dentist-employers may reduce the time available for managed care patients in order to allow longer appointments for more profitable fee-for-service patients. The study results did not support the notion that managed care affects the extent to which dental hygienists perform periodontal procedures. These mixed results suggest that future research should examine the relationships between managed care and other aspects of quality of dental hygiene care not addressed in the current study.
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