Are clinical decisions in endodontics influenced by the patient's fee-paying status?

Key Points Shows that an analogue study might be helpful in exploring clinical decision making in the dental surgery. Reports that for the cohort of participants in this study, there was no evidence to support the fee status of the patient impacting treatment prescription. Objective We explored whet...

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Bibliographic Details
Published in:British dental journal 2015-12, Vol.219 (11), p.541-545
Main Authors: Walker, I., Gilbert, D., Asimakopoulou, K.
Format: Article
Language:English
Subjects:
692/700/3032/3099/3120
692/700/3032/3123
692/700/3934
Adult
Clinical Decision-Making
Dental Pulp Diseases - economics
Dental Pulp Diseases - surgery
Dentistry
Endodontics - economics
Female
Humans
Insurance, Dental
Male
Medicine
State Medicine
Surveys and Questionnaires
Tooth Extraction - economics
United Kingdom
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Summary:Key Points Shows that an analogue study might be helpful in exploring clinical decision making in the dental surgery. Reports that for the cohort of participants in this study, there was no evidence to support the fee status of the patient impacting treatment prescription. Objective We explored whether the fee status of a UK patient influences clinical decision-making in endodontics. Subjects and methods In a randomised-controlled vignette study describing either an 'NHS-funded', 'Privately-funded' or undisclosed fee-status patient, we examined the importance vocational trainer dentists placed on a series of factors normally considered when deciding whether to offer patients endodontic treatment as opposed to extracting the tooth. N = 119 experienced (M years post qualification = 20.01) dentists participated. Main outcome measures Having read a vignette describing a hypothetical patient who could potentially be treated either endodontically or through an extraction, dentists rated a series of factors they would normally consider (for example, poor oral hygiene, the rest of their mouth is unfilled and caries-free), before recommending either endodontic treatment or an extraction. Results The patient's funding status had no influence on these dentists' clinical decision-making when considering endodontic treatment as an option (p >0.05) with the exception of a single item relating to infrequent attendance where the NHS patient was more likely than the 'undisclosed-fee' patient, to be offered extractions (F (2, 116) 3.43, p
ISSN:0007-0610
1476-5373
DOI:10.1038/sj.bdj.2015.921