Practice Characteristics Associated with Patient-Specific Receipt of Dental Diagnostic Radiographs

Authors

  • Gregg H. Gilbert,

    1. Department of Diagnostic Sciences, UAB School of Dentistry, SDB Room 109, 1530 3rd Avenue South, Birmingham, AL 35294-0007,
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    • Address correspondence to Gregg H. Gilbert, D.D.S., M.B.A., Professor and Chair, Department of Diagnostic Sciences, UAB School of Dentistry, SDB Room 109, 1530 3rd Avenue South, Birmingham, AL 35294-0007. Richard A. Weems, D.M.D., M.S., Associate Professor, is with the Department of Diagnostic Sciences, UAB School of Dentistry, Birmingham, AL. Mark S. Litaker, Ph.D., Associate Professor, is with the Department of Diagnostic Sciences, Director of Biostatistics, UAB School of Dentistry, Birmingham, AL. Brent J. Shelton, Ph.D., Associate Professor, is with the Department of Biostatistics, University of Kentucky Markey Cancer Control Program, Lexington, KY.

  • Richard A. Weems,

    1. Department of Diagnostic Sciences, UAB School of Dentistry, Birmingham, AL,
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  • Mark S. Litaker,

    1. Department of Diagnostic Sciences, Director of Biostatistics, UAB School of Dentistry, Birmingham, AL
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  • Brent J. Shelton

    1. Department of Biostatistics, University of Kentucky Markey Cancer Control Program, Lexington, KY
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Abstract

Objective. To quantify the role of practice characteristics in patient-specific receipt of dental diagnostic radiographic services.

Data Source/Study Setting. Florida Dental Care Study (FDCS).

Study Design. The FDCS was a 48-month prospective observational cohort study of community-dwelling adults. Participants' dentists were asked to complete a questionnaire about their practice characteristics.

Data Collection/Extraction Methods. In-person interviews and clinical examinations were conducted at baseline, 24, and 48 months, with 6-monthly telephone interviews in between. A single multivariate (four radiographic service outcomes) multivariable (multiple explanatory covariates) logistic regression was used to model service receipts.

Principal Findings. These practice characteristics were significantly associated with patient-specific receipt of radiographic services: number of different practices attended during follow-up; dentist's rating of how busy the practice was; typical waiting time for a new patient examination; practice size; percentage of patients that the dentist reported as interested in details about the condition of their mouths; percentage of African American patients in the practice; percentage of patients in the practice who do not have dental insurance; and dentist's agreement with a statement regarding whether patients should be dismissed from the practice. Effects had differential magnitudes and directions of effect, depending upon radiograph type.

Conclusions. Practice characteristics were significantly associated with patient-specific receipt of services. These effects were independent of patient-specific disease level and patient-specific sociodemographic characteristics, suggesting that practitioners do influence receipt of these diagnostic services. These findings are consistent with the conclusion that practitioners act in response to a mix of patients' interests, economic self-interests, and their own treatment preferences.

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