IADR Abstract Archives
Opinions and Barriers to Reforming Dental Policy of the Japanese Universal-Health-Care System.
Objectives: The Japanese universal health care coverage system is facing critical financial problems due to its growing elderly population. A new model of the Japanese universal healthcare system with five modifications was created and evaluated by dental practitioners and dental school faculty.
Methods: A proposed new model has five modifications: 1) full insurance coverage for prevention and examination (100PreEx), 2) implementation of teaching practices (ITP), 3) reduction in the frequency of redo/remakes (RR), 4) implementation of a patient incentive system (ICT), and 5) increase in treatment fees (ITF). An anonymous online survey with 30 questions was used to assess the dentist’s opinions, potential barriers, and outcome expectations. Furthermore, the data was compared on three factors; age, gender, and employment type (Faculty or Private practitioner) using Chi-square for independence test. This study was approved by Harvard Medical School’s IRB.
Results: The 316 surveys were distributed and 308 dentists (77%: male and 23%:female) answered the survey. Fifty-eight percent of participants agreed to 100PreEx and 74% to ITP. Only 50% of participants agreed to reduce the allowable frequency of RR. The most significant barriers pointed out were a large variation in the level of experience among dentists, patient cooperation, and a lack of clinical faculty. There was strong agreement on ITF, especially for endodontic treatment (p<0.01). There was overall agreement on ICT; however, there was a significant difference in outcome expectations. Younger dentists had more positive expectations that an incentive system would improve patient motivation for oral health (p<0.01).
Conclusions: The majority of dentists who participated in this survey agreed with the dental policy reforms presented, and various barriers and resistance were also highlighted. A new policy system that can improve quality of care, clinical education, patient motivation, treatment fees, and enhance prevention is critically needed.
Methods: A proposed new model has five modifications: 1) full insurance coverage for prevention and examination (100PreEx), 2) implementation of teaching practices (ITP), 3) reduction in the frequency of redo/remakes (RR), 4) implementation of a patient incentive system (ICT), and 5) increase in treatment fees (ITF). An anonymous online survey with 30 questions was used to assess the dentist’s opinions, potential barriers, and outcome expectations. Furthermore, the data was compared on three factors; age, gender, and employment type (Faculty or Private practitioner) using Chi-square for independence test. This study was approved by Harvard Medical School’s IRB.
Results: The 316 surveys were distributed and 308 dentists (77%: male and 23%:female) answered the survey. Fifty-eight percent of participants agreed to 100PreEx and 74% to ITP. Only 50% of participants agreed to reduce the allowable frequency of RR. The most significant barriers pointed out were a large variation in the level of experience among dentists, patient cooperation, and a lack of clinical faculty. There was strong agreement on ITF, especially for endodontic treatment (p<0.01). There was overall agreement on ICT; however, there was a significant difference in outcome expectations. Younger dentists had more positive expectations that an incentive system would improve patient motivation for oral health (p<0.01).
Conclusions: The majority of dentists who participated in this survey agreed with the dental policy reforms presented, and various barriers and resistance were also highlighted. A new policy system that can improve quality of care, clinical education, patient motivation, treatment fees, and enhance prevention is critically needed.