First do no harm –: The impact of financial incentives on dental x-rays

Martin John Chalkley; Stefan Listl

First do no harm –: The impact of financial incentives on dental x-rays

Centre for Health Economics

Research output: Working paper › Discussion paper

Abstract

This paper assesses the impact of dentist remuneration on the incidence of potentially harmful dental x-rays. We use unique panel data which provide details of 1.3 million treatment claims by Scottish NHS dentists made between 1998 and 2007. Controlling for unobserved heterogeneity of both patients and dentists we estimate a series of fixed-effects models that are informed by a theoretical model of x-ray delivery and identify the effects on dental x-raying of dentists moving from a fixed salary to fee-for-service and patients moving from co-payment to exemption. We establish that there are significant increases in x-rays when dentists receive fee for service rather than salary payments and
patients are made exempt from payment. There are further increases in x-rays when a patient switches to a fee for service dentist relative to them switching to a salaried one.

Original language	English
Place of Publication	York, UK
Publisher	Centre for Health Economics, University of York
Pages	1-22
Number of pages	22
Publication status	Published - Feb 2017

Publication series

Name	CHE Research Papers
Publisher	Centre for Health Economics, York University, York, UK
No.	143

Keywords

HEALTH CARE
INCENTIVES
Matched data
dentistry

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CHERP143_impact_financial_incentives_dental_xraysFinal published version, 1.13 MB

https://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP143_impact_financial_incentives_dental_xrays.pdf

Cite this

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AB - This paper assesses the impact of dentist remuneration on the incidence of potentially harmful dental x-rays. We use unique panel data which provide details of 1.3 million treatment claims by Scottish NHS dentists made between 1998 and 2007. Controlling for unobserved heterogeneity of both patients and dentists we estimate a series of fixed-effects models that are informed by a theoretical model of x-ray delivery and identify the effects on dental x-raying of dentists moving from a fixed salary to fee-for-service and patients moving from co-payment to exemption. We establish that there are significant increases in x-rays when dentists receive fee for service rather than salary payments andpatients are made exempt from payment. There are further increases in x-rays when a patient switches to a fee for service dentist relative to them switching to a salaried one.

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