THE RELATIONSHIP BETWEEN PRICE OF SERVICES, QUALITY OF CARE, AND PATIENT TIME COSTS FOR GENERAL DENTAL PRACTICE

Objective. To examine the relationships between price of services, qua lity of care, and patient time costs in private practices of general d entists. Data Source/Study Setting. In October 1992, a 3.7 percent sam ple of eligible general dentists in part-time or full-time private pra ctice in 1991 was randomly drawn from a sampling frame tailored from d ata gathered by the 1991-1992 American Dental Association Distribution of Dentists census of all United States dentists. Data Collection. A mail survey was used to collect data on dentist demographic characteri stics, dental practice characteristics, practice finances, and insuran ce. The survey was completed and returned by 3,048 general dentists (7 7 percent response rate). Local area population characteristics were o btained from secondary sources. Study Design. Two-stage least squares regression was used to evaluate the structural relationships between p rice of services, quality of care, and time costs to patients. Structu ral equations were estimated for four different quality of care measur es and two time costs. Principal Findings. Price of services and quali ty of care were significantly related to each other. Higher quality of care was associated with higher price of services and, reciprocally, higher price of services was associated with higher quality of care. S horter waits for a new patient appointment were associated with higher prices. Higher price of services, lower quality of care, and longer w aits for a new patient appointment were related to shorter in-office w aiting time. Conclusion. The implication of these findings is that if price of services is constrained, then the quality of care provided by the dentist may also be reduced.