IADR Abstract Archives
Variation in endodontic malpractice incidences by regional demographics in Finland
Objectives: We evaluated the roles of population demographics and oral health care supply in endodontic malpractice incidences in Finland in the 2000s.
Methods: In Finland, adults can use both private and public sector dental care; around 6% of all treatments are endodontics. The Patient Insurance Centre (PIC) handles health care claims and awards patients with financial compensation in cases where following good clinical practice could have avoided patient injury.
We analyzed a total of 1,271 claims across 8 years: 668 cases in 2002-2006 and 603 in 2011-2013. Data are based on original patient documents which the PIC requires from the operators. Two PIC dental advisors, both specialists in endodontics, scrutinized the cases and recorded patients’ details. PIC classifies the cases as unavoidable injuries, avoidable injuries, or no injury. Based on patients’ postal address we harvested regional demographics about their hospital districts (SHP) from open databases by Statistics of Finland and Social Insurance Institution. We combined the 3 smallest SHPs, each to its closest neighbor, and aggregated patient-based data by the SHPs (n=18). Dentist-population ratios refer to numbers of work-age dentists. EDUC-index describes regional level of education, later categorized as low, middle and high. Statistical evaluation included Pearson correlation coefficient.
Results: Population per SHP ranged from 78,000 to 1.5 million and dentist-population ratio from 1:1,016 to 1:1,732; claimant-patients’ mean age by SHP was 45.2 years (SD=3.5; range 37.8-51.7). EDUC-index was low for 6 SHPs, middle for 9 and high for 3. Mean number of endodontic malpractice claims per 100,000 inhabitants by SHP was 2.3 (SD=1.0; range 0.5-4.7) and of verified endodontic injuries, 1.7 (SD=0.7; range 0.5-3.5) being more common in those SHPs with larger population (r=0.67; p=0.001), higher educational level (r=0.63; p=0.003) and smaller dentist-population ratio (r=-0.43; p=0.04).
Conclusions: Endodontic malpractice incidents were over-presented in regions with large and highly educated population and high supply of oral health care.
Methods: In Finland, adults can use both private and public sector dental care; around 6% of all treatments are endodontics. The Patient Insurance Centre (PIC) handles health care claims and awards patients with financial compensation in cases where following good clinical practice could have avoided patient injury.
We analyzed a total of 1,271 claims across 8 years: 668 cases in 2002-2006 and 603 in 2011-2013. Data are based on original patient documents which the PIC requires from the operators. Two PIC dental advisors, both specialists in endodontics, scrutinized the cases and recorded patients’ details. PIC classifies the cases as unavoidable injuries, avoidable injuries, or no injury. Based on patients’ postal address we harvested regional demographics about their hospital districts (SHP) from open databases by Statistics of Finland and Social Insurance Institution. We combined the 3 smallest SHPs, each to its closest neighbor, and aggregated patient-based data by the SHPs (n=18). Dentist-population ratios refer to numbers of work-age dentists. EDUC-index describes regional level of education, later categorized as low, middle and high. Statistical evaluation included Pearson correlation coefficient.
Results: Population per SHP ranged from 78,000 to 1.5 million and dentist-population ratio from 1:1,016 to 1:1,732; claimant-patients’ mean age by SHP was 45.2 years (SD=3.5; range 37.8-51.7). EDUC-index was low for 6 SHPs, middle for 9 and high for 3. Mean number of endodontic malpractice claims per 100,000 inhabitants by SHP was 2.3 (SD=1.0; range 0.5-4.7) and of verified endodontic injuries, 1.7 (SD=0.7; range 0.5-3.5) being more common in those SHPs with larger population (r=0.67; p=0.001), higher educational level (r=0.63; p=0.003) and smaller dentist-population ratio (r=-0.43; p=0.04).
Conclusions: Endodontic malpractice incidents were over-presented in regions with large and highly educated population and high supply of oral health care.