Patient Attendances as a Predictor of Work Done in Clinics

Objectives: To evaluate how well the number of patient attendances reflect the productivity of dentists in the public dental services in the Western Cape Province. Methods: Data on all services rendered in this province are captured on a management information system, the Public Dental Evaluation (PDE) system. Data from all the quarterly totals of dentists (n=3706) for the period 1994 – 2009 was analysed. Work done after hours (commuted overtime) was not included in this study. Three different Relative Value Units (RVU's) were used to quantify the amount of work carried out: a, the 2009 Tariffs used in the private sector, b, the old RVU's that were used prior to 1994 using the Z804 form, and c, the PDE RVU's that have been adapted from the other RVU's but weighted in favour of primary and secondary prevention. Using linear regression, the number of patients seen by each dentist was compared to the production units for each quarter of the year to see how well the attendance count could predict production. Results: Patient attendances were a good predictor of work done by the dentists when production is measured by means of treatment tariffs (R² =0.80). The regression co-efficient was smaller for the old RVU's (R²=0.58) and the PDE RVU's (R²=0.31). All these regression coefficients were statistically significant (p<0.0001). Conclusion: Since treatment tariffs do not cover community prevention programmes, and the weighting of both the tariffs and the old RVU's are biased in favour of extractions, the count of patient attendances would only be good to predict the work done in an extraction clinic where little primary preventive work is done. Therefore, patient attendances are not a good predictor for work that should be done by dentists in the public sector.