Satisfaction with publicly funded primary care services in Britain 1998-2018

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Abstract

Objectives: Patients satisfaction with primary care dental services is a function of quality including access and expense. In the UK publicly, funded dentistry is delivered ostensibly by self-employed general dental practitioners. The supply of effort by such dentists to the publicly funded system will depend on public reimbursement arrangements and administrative costs relative to those that can be achieved from private patients. In this paper we examine changes in client satisfaction over 21 years in Britain and relate this to changes in reimbursement arrangements and the broader economic climate.
Methods: We use data on respondent satisfaction and socio-demographic characteristics taken from successive British Social Attitudes Surveys between 1998 and 2018. We exploit a change in reimbursement arrangements in England and Wales relative to those in Scotland and the economic downturn following the financial crisis in 2008 to create natural experiments. Logistic regression analysis with time trend is used to compare satisfaction between Scotland and the rest of Britain controlling for a range of socio-demographic characteristics.
Results: Just over 35,500 responses with complete data were extracted from the surveys. On average 71% of respondents were satisfied or very satisfied with NHS dental services, the average age of the sample was 48.73 years, 17.89% had a degree or above, 56.16% were married and 32.85% had children living at home. Controlling for other variables, satisfaction in Scotland was higher than that in England/Wales throughout the 20 years. Relative satisfaction diverged between 2005 and 2009 and converged between 2010 and 2018 such that significant differences evident in earlier periods were eradicated by 2012.
Conclusions: Satisfaction with NHS dental services in England/Wales largely tracked that in Scotland diverging slightly in immediate prelude to and aftermath of a change in reimbursement arrangements in England/Wales. Changes in relative satisfaction were though dominated by the financial crisis.
Original languageEnglish
JournalJournal of Dental Research
Publication statusAccepted - 05 Feb 2021
EventIrish Division of the International Association for Dental Research (IADR) Annual Scientific Meeting -
Duration: 05 Feb 202105 Feb 2021

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