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The efficiency of the public dental services (PDS) in Cyprus and selected determinants.

Charalambous C, Maniadakis N, Polyzos N, Fragoulakis V, Theodorou M - BMC Health Serv Res (2013)

Bottom Line: Urban areas and low time per patient are predictors of increased efficiency.The results suggest that many of the rural PDS are underperforming.Given that the option of shutting them down is undesirable, measures should be taken to reduce inputs (e.g. by reducing the personnel's working hours) and to increase outputs (remove barriers, make PDS more accessible and increase the number of patients).

View Article: PubMed Central - HTML - PubMed

Affiliation: Open University of Cyprus, Lemesou Avenoue 2, Aluminium Tower, 2003, Strovolos, Lefkosia, Cyprus. nmaniadakis@esdy.edu.gr.

ABSTRACT

Background: Currently there is a dual system of oral healthcare delivery in Cyprus: the public dental system (PDS) run by the Government and the private system provided by private dental practitioners. Although 83% of the population is entitled to free treatment by the PDS only 10% of the population make use of them. As Cyprus faces now the challenges of the introduction of a new health care system and rising healthcare costs in general, surveys that examine, among other things, the efficiency of the PDS become very important as tools to make important cost savings. The aims of this study are to assess trends regarding the number of visits and the age distribution of patients using PDS from 2004 to 2007, to measure the technical efficiency of the PDS and to investigate various factors that may affect it.

Methods: Non-parametric Data Envelopment Analysis (DEA) was employed to assess technical efficiency. Two separate cases were examined. Efficiency was calculated, firstly using as inputs the wages and the working hours of the personnel, and secondly the working hours of the personnel and the cost of the materials. As outputs, in both cases, the treatment offered (divided into primary, secondary and tertiary care) and the numbers of visits were used. In the second stage Tobit analysis was used to explore various predictors of efficiency (time per patient, location, age of dentists, age of patients and age of assistants).

Results: The study showed that whilst there was an increase in the number of patients using the PDS from 2004 to 2007, only a small proportion of the population (10%) make use of them. Women, middle and older aged patients, make more use of the PDS. Regarding efficiency, there were large differences between the units. The average Technical Efficiency score was 68% in the first model and 81% in the second. Urban areas and low time per patient are predictors of increased efficiency.

Conclusion: The results suggest that many of the rural PDS are underperforming. Given that the option of shutting them down is undesirable, measures should be taken to reduce inputs (e.g. by reducing the personnel's working hours) and to increase outputs (remove barriers, make PDS more accessible and increase the number of patients).

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Visits in urban health centre departments by age, sex and year.
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Figure 3: Visits in urban health centre departments by age, sex and year.

Mentions: Figures 2, 3 and 4 present the number of patients who visited alternative dental health provision service places by sex, age and year. It is noticeable that women make more use of the public dental services. In both hospitals and urban health centres the age group that makes most use of the public dental services is 45–65 years, whilst in rural health centres that age group is 65–74 years. It is obvious that the patients that are visiting rural health centres are older compare to those that are visiting urban health centres or hospitals. Furthermore, as indicated in Figure 5 there was an increase in the number of visits between 2004 and 2007 both at hospitals (7.00%) and urban health centres (31.32%) but a decrease at rural health centres (5.11%). The increase in the number of visits at urban health centres was to be expected as a result of the migration of population from rural into urban areas. It was also thought that because urban health centres are located in new and modern buildings this may make it more attractive for patients to visit them although it must be clarified that all health centres are well equipped and have the same dental units and use the same materials This should be taken into consideration in the future regarding human resource planning. As far as hospitals are concerned it is worth mentioning that from 2004 until 2006 the number of visits was stable, followed by an increase in 2007. This needs to be examined further with regard to the underlying reasons and to whether it is likely to continue in the future.


The efficiency of the public dental services (PDS) in Cyprus and selected determinants.

Charalambous C, Maniadakis N, Polyzos N, Fragoulakis V, Theodorou M - BMC Health Serv Res (2013)

Visits in urban health centre departments by age, sex and year.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016280&req=5

Figure 3: Visits in urban health centre departments by age, sex and year.
Mentions: Figures 2, 3 and 4 present the number of patients who visited alternative dental health provision service places by sex, age and year. It is noticeable that women make more use of the public dental services. In both hospitals and urban health centres the age group that makes most use of the public dental services is 45–65 years, whilst in rural health centres that age group is 65–74 years. It is obvious that the patients that are visiting rural health centres are older compare to those that are visiting urban health centres or hospitals. Furthermore, as indicated in Figure 5 there was an increase in the number of visits between 2004 and 2007 both at hospitals (7.00%) and urban health centres (31.32%) but a decrease at rural health centres (5.11%). The increase in the number of visits at urban health centres was to be expected as a result of the migration of population from rural into urban areas. It was also thought that because urban health centres are located in new and modern buildings this may make it more attractive for patients to visit them although it must be clarified that all health centres are well equipped and have the same dental units and use the same materials This should be taken into consideration in the future regarding human resource planning. As far as hospitals are concerned it is worth mentioning that from 2004 until 2006 the number of visits was stable, followed by an increase in 2007. This needs to be examined further with regard to the underlying reasons and to whether it is likely to continue in the future.

Bottom Line: Urban areas and low time per patient are predictors of increased efficiency.The results suggest that many of the rural PDS are underperforming.Given that the option of shutting them down is undesirable, measures should be taken to reduce inputs (e.g. by reducing the personnel's working hours) and to increase outputs (remove barriers, make PDS more accessible and increase the number of patients).

View Article: PubMed Central - HTML - PubMed

Affiliation: Open University of Cyprus, Lemesou Avenoue 2, Aluminium Tower, 2003, Strovolos, Lefkosia, Cyprus. nmaniadakis@esdy.edu.gr.

ABSTRACT

Background: Currently there is a dual system of oral healthcare delivery in Cyprus: the public dental system (PDS) run by the Government and the private system provided by private dental practitioners. Although 83% of the population is entitled to free treatment by the PDS only 10% of the population make use of them. As Cyprus faces now the challenges of the introduction of a new health care system and rising healthcare costs in general, surveys that examine, among other things, the efficiency of the PDS become very important as tools to make important cost savings. The aims of this study are to assess trends regarding the number of visits and the age distribution of patients using PDS from 2004 to 2007, to measure the technical efficiency of the PDS and to investigate various factors that may affect it.

Methods: Non-parametric Data Envelopment Analysis (DEA) was employed to assess technical efficiency. Two separate cases were examined. Efficiency was calculated, firstly using as inputs the wages and the working hours of the personnel, and secondly the working hours of the personnel and the cost of the materials. As outputs, in both cases, the treatment offered (divided into primary, secondary and tertiary care) and the numbers of visits were used. In the second stage Tobit analysis was used to explore various predictors of efficiency (time per patient, location, age of dentists, age of patients and age of assistants).

Results: The study showed that whilst there was an increase in the number of patients using the PDS from 2004 to 2007, only a small proportion of the population (10%) make use of them. Women, middle and older aged patients, make more use of the PDS. Regarding efficiency, there were large differences between the units. The average Technical Efficiency score was 68% in the first model and 81% in the second. Urban areas and low time per patient are predictors of increased efficiency.

Conclusion: The results suggest that many of the rural PDS are underperforming. Given that the option of shutting them down is undesirable, measures should be taken to reduce inputs (e.g. by reducing the personnel's working hours) and to increase outputs (remove barriers, make PDS more accessible and increase the number of patients).

Show MeSH
Related in: MedlinePlus