AN ASSESSMENT OF CAPITATION IN THE GENERAL DENTAL SERVICE CONTRACT .2. PATTERNS OF TREATMENT PROVIDED TO REGULARLY ATTENDING PATIENTS

Objective To compare the patterns of treatment of general dental pract ioners working under fee-for-service in 1987/88 with those working und er capitation in 1992/93. Design 73 randomly selected general dental p ractitioners working under capitation in three contrasting areas in En gland retrospectively recorded the treatment provided during 1992/93 t o a random selection of their regularly attending 6-12 and 14-15-year- old patients. Results Mean numbers of examinations per year reduced in the three areas from 1.7-1.8 in 1987/88 to 1.2-1.4 in 1992/93. Mean n umbers of visits per patient dropped from 2.5-2.9 to 1.8-2.2. Mean num bers of fillings in permanent teeth reduced from 0.15-1.04 to 0.09-0.5 2 and in deciduous teeth from 0.28-0.53 to 0.24-0.31. Mean percentages of children per dentist having extractions fell from 9.3-28.1% to 4.7 -16.2% while the radiographs reduced from 14.0-9.0% to 6.0-10.6%. Mean percentages of children per dentist receiving oral hygiene instructio n rose from 18-31% in 1987/88 to 26-33% in 1992/93. Dietary advice inc reased from 3-18% to 11-20% and fissure sealants from 3-6% to 3-12%. C onclusions In 1992/93, dentists working under capitation were carrying out fewer examinations, fillings and extractions and were taking fewe r radiographs for their regularly attending child and adolescent patie nts than dentists working under fee-for -service in 1987/88. These pat ients also attended less frequently for treatment but received margina lly more preventive care and advice.