Dentists and Incentive Remuneration – Effects on Service Production and Quality

The aim of the project is to study the effect of different types of contract on dentists’ service production. The study is carried out in the county of Østfold and includes almost the whole population of public dental officers in this county. In 2000 a pi lot scheme was introduced, in which public dental officers, if they so wished, could change from a fixed salary contract to a contract with a combination of per capita and fixed salary remuneration. Those who wished to continue with a normal fixed salary contract could do so. We evaluate the effect of the two types of contract on service production (number of patients on the list, number of consultations and number of consultations per hour), on morbidity (caries), treatment profiles and on information a bout prevention given by the dentists to patients. A strength of the project is that we can distinguish between the effect on service production of dentists’ preferences for working a lot (the selection effect) and the effect on service production of the actual system of remuneration (the incentive effect). It is also interesting to study how an incentive-based remuneration system influences oral health (the level of caries), and dentists’ treatment profiles (when and how often they restore teeth). We ha ve the necessary data for before and after introduction of the pilot scheme, on paper. We can obtain the extra data we need from patient records (for example from radiographs). We apply for economic support for registering the data, preparing the data for analysis and producing the report. The results are very valuable for the on-going debate about how the public dental services in Norway can be more effective. Both in terms of its size and geographic position, Østfold is representative of the dental serv ices in the other counties in southern Norway, and the results therefore have transfer value for these other counties.