Utilisation of dental services in Tanzania before and after the introduction of cost-sharing

Objective: The objective of this study was to evaluate the effect of cost-s haring, introduced in July 1994, on the utilisation of dental services in T anzania. Methods: The study compared dental attendance, demand for dental s ervices and treatment pattern of patients in 17 out of 20 regions of mainla nd Tanzania in 1993 and 1995, a year before and after the introduction of u ser fees. Outcomes measures: Dental attendance and demand for treatment. Re sults: Results revealed a 33.2 per cent overall reduction in dental attenda nce but no effect on either the demand for treatment or treatment pattern. The exceptions were increases in referral cases by 14.5 times and prostheti c work by 3.9 times, and a reduction in surgical cases by 18.8 per cent. Co nclusions: In order to improve attendance and decrease referrals it is nece ssary to enforce the first line of oral primary health care to meet the sim ple treatment demands. Furthermore, the revenue generated by cost-sharing s hould be used to improve services.