Geographic variations in dental services provided to older adults in Ontario, Canada

In an initial study, Leake et al. (J Public Health Dent 1996; 52: 182-90) f ound that older Ontarians living in metropolitan communities received almos t twice the amount of dental care than older Ontarians Living in non-metrop olitan communities. Since data were collected for the 2 years prior to the enrolment of subjects in a longitudinal study, factors responsible for this variation could not be explored. This paper extends these findings by exam ining the Volume of dental services received by these subjects in the 3 yea rs between the baseline and followup phases of the longitudinal study. Duri ng this 3-year period, geographic variations in the volume of services prov ided were also observed. In a regression analysis, geographic location rema ined a significant predictor of the number of services received after contr olling for six other explanatory variables: insurance coverage, number of t eeth, restorative treatment need, self-rated oral health, regular dental vi sits and use of specialist services. Together, these explained only 24% of the variance in service provision. Since patient-reported outcomes were bet ter in the communities with higher volumes of provision, further research c oncerning the patient and dentist factors influencing treatment provision i s warranted.