Patients' Experience of Capitation Dental Plan System

Objective: A capitation plan system i.e. oral health care to a prepayment scheme (cf. dental care insurance) has been introduced by all Public Dental Services in Sweden during the last decade. The patients are offered to pay the oral health care either in a prepayment scheme or the traditional fee-for-service system. Those who choose the capitation system pay a monthly or yearly fee according to a risk classification made by the dentist or the dental hygienist. The aim of this study was to describe experience of a prepayment scheme among patients who prolonged the agreement.

Method: The study was exploratory with a qualitative approach. Sixteen respondents were interviewed using a semi-structured interview guide. The interviews were tape-recorded, transcribed verbatim, and analyzed in a coding process. The analysis was made with qualitative content analysis.

Results: In the analysis one main theme was identified: ‘An opportunity to maintain good oral health but a sense of ambiguity to the risk classification’.  This core theme was related to four categories: ‘Possibility to get regularly dental care’, ‘Incentive to take preventive actions’ ‘Uncertainty of getting adequate dental care’, and ‘Barriers for entering into the system’.

Conclusions: The study demonstrated that the prepayment scheme was regarded as a possibility to get regular dental care and a motivation to perform self-care procedures. On the other hand, they also had doubts of getting necessary dental care and concerns about barriers for being allowed to take part of the system.