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Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment

Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment
Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment
Background: the aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments – such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them.

Methods/Design: mixed methods will be employed to provide insight and understanding into how clinical need is determined, and what influences people's decision making processes when deciding whether or not to pursue a dental implant treatment. Phase 1 will use a structured scoping questionnaire with all the General dental practitioners (GDPs) in three Primary Care Trust areas (n = 300) to provide base-line data about existing practice in relation to dental implant treatment, and to provide data to develop a systematic sampling procedure for Phase 2. Phases 2 (GDPs) and 3 (patients) use qualitative focused one to one interviews with a sample of these practitioners (up to 30) and their patients (up to 60) to examine their views and experiences of decision making in relation to dental implant treatment. Purposive sampling for phases 2 and 3 will be carried out to ensure participants represent a range of socio-economic circumstances, and choices made.

Discussion: most dental implant treatment is conducted in primary care. Very little information was available prior to this study about the quantity and type of treatment carried out privately. It became apparent during phase 2 that ISOD treatment was an unusual treatment in primary care. We thus extended our sample criteria for Phase 3 to include people who had had other implant supported restorations, although not single tooth replacements
1472-6963
7-[8pp]
Exley, Catherine E
b83c60e0-f179-4beb-8044-55cc532ee411
Rousseau, Nikki S
c5956be7-faac-4a46-9c28-589a5df17554
Steele, Jimmy
043e6465-e20a-4bf3-b23f-ac06a62d3713
Finch, Tracy
b1916307-8516-4b70-8ba5-05d3310839de
Field, James
7386718a-25bb-4247-b499-9f640c10171f
Donaldson, Cam
7bed1418-f75f-4e11-aa7c-9c854163bbbb
Thomason, J Mark
5c334f6f-ccec-4f91-baef-3735eacf4e4c
May, Carl
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Ellis, Janice S
f1e86e24-8458-4ac3-98c5-6d8d0803aa52
Exley, Catherine E
b83c60e0-f179-4beb-8044-55cc532ee411
Rousseau, Nikki S
c5956be7-faac-4a46-9c28-589a5df17554
Steele, Jimmy
043e6465-e20a-4bf3-b23f-ac06a62d3713
Finch, Tracy
b1916307-8516-4b70-8ba5-05d3310839de
Field, James
7386718a-25bb-4247-b499-9f640c10171f
Donaldson, Cam
7bed1418-f75f-4e11-aa7c-9c854163bbbb
Thomason, J Mark
5c334f6f-ccec-4f91-baef-3735eacf4e4c
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Ellis, Janice S
f1e86e24-8458-4ac3-98c5-6d8d0803aa52

Exley, Catherine E, Rousseau, Nikki S, Steele, Jimmy, Finch, Tracy, Field, James, Donaldson, Cam, Thomason, J Mark, May, Carl and Ellis, Janice S (2009) Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment. BMC Health Services Research, 9, 7-[8pp]. (doi:10.1186/1472-6963-9-7).

Record type: Article

Abstract

Background: the aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments – such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them.

Methods/Design: mixed methods will be employed to provide insight and understanding into how clinical need is determined, and what influences people's decision making processes when deciding whether or not to pursue a dental implant treatment. Phase 1 will use a structured scoping questionnaire with all the General dental practitioners (GDPs) in three Primary Care Trust areas (n = 300) to provide base-line data about existing practice in relation to dental implant treatment, and to provide data to develop a systematic sampling procedure for Phase 2. Phases 2 (GDPs) and 3 (patients) use qualitative focused one to one interviews with a sample of these practitioners (up to 30) and their patients (up to 60) to examine their views and experiences of decision making in relation to dental implant treatment. Purposive sampling for phases 2 and 3 will be carried out to ensure participants represent a range of socio-economic circumstances, and choices made.

Discussion: most dental implant treatment is conducted in primary care. Very little information was available prior to this study about the quantity and type of treatment carried out privately. It became apparent during phase 2 that ISOD treatment was an unusual treatment in primary care. We thus extended our sample criteria for Phase 3 to include people who had had other implant supported restorations, although not single tooth replacements

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Published date: January 2009

Identifiers

Local EPrints ID: 163597
URI: http://eprints.soton.ac.uk/id/eprint/163597
ISSN: 1472-6963
PURE UUID: f4d1eec0-ec76-43ba-b9ee-b459c4f4761d
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690

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Date deposited: 09 Sep 2010 13:42
Last modified: 31 Jul 2019 00:37

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Contributors

Author: Catherine E Exley
Author: Nikki S Rousseau
Author: Jimmy Steele
Author: Tracy Finch
Author: James Field
Author: Cam Donaldson
Author: J Mark Thomason
Author: Carl May ORCID iD
Author: Janice S Ellis

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