A longitudinal study of young Finnish adults' use of subsidized, private sector dental care, 1986-1997

Objectives: Finns born after 1956 are now entitled to subsidized private se ctor dental care, or such persons could be enrolled in the Public Dental Se rvice. Until 1986, eligibility was more restrictive. The purpose of this st udy was to investigate the use and costs of private dental care and effects of regularity of care on costs and treatment received among young Finnish adults during 1986-1997. Methods: All 1986, 1990 and 1994 recipients of rei mbursement for dental care from the Social Insurance Institution were inclu ded in the study. Five separate age cohorts were compared. Using their civi l registration numbers, individuals were tracked from their first contact w ith a private dentist in one of the years 1986, 1990 or 1994 until the year 1997. Results: While the total number of young adults who had received rei mbursement for private dental care increased from about 53 000 (1986) to 20 0 000 (1994) due to extended eligibility, the number of users in the younge st group decreased from 53 000 to 23 000. Attending infrequently (1-2 times during the study period) was most common among the youngest adults and fre quent attendance (annually) was most common among older adults. The annual mean cost was slightly lower among the frequent attenders in almost every c ohort. Variation in the mean number of annual visits was directly correlate d with costs. Frequent attenders most often received diagnostic and prevent ive measures while restorations and surgery were most common for the infreq uent attenders. Conclusions: A substantial decline in the demand for privat e services among the 19-25-year-olds and stable demand among 26-34-year-old s was detected, indicating falling treatment needs or a preference for the Public Dental Service. All groups had a stable mean number of visits per ye ar and almost constant costs. The mean number of dental visits per year rem ained steady in all cohorts indicating rigid treatment patterns.