Produktion, produktivitet och kostnader i svensk tandvård

Sammanfattning: The thesis contains projects at a national as well as a clinical level.On a national level a study is made of productivity in adult dental care in both its private and its public·sectors. By using the calculated productivity for the years 1975-1984 a variety of factors are tested for the ability to explain firstly the development of productivity in private dental care and in public dental care respectively, and secondly the differences in productivity between the two sectors.The productivity measures used are the number of patients treated per dentist hour and the dentist fee per dentist hour. The results show in the case of the first mentioned productivity measure a somewhat higher value for public dental care for all of the years studied. For the productivity measures, dentist's fee per dentist hour, private dental care shows a 20-30 percent higher productivity.Differences in the age structure of the patients and different treatment panoramas can explain a great many of the differences in productivity. However the question is why the treatment panoramas of the two sectors are so different, a difference that can scarcely be explained by differences in the patient population. There are grounds, therefore, for believing that the differences can be explained on the basis of differences in the activity goals of the two sectors.As a complement to the productivity studies outlined above the costs of treating a patient have also been compared. The results show considerably higher costs in public dental care, though the difference has been greatly reduced during the 80s due largely to a lower rate of increase in the overheads of dentists in the public sector over the last few years.The second study comprises a production economic study of 144 public dental care clinics in five counties in southern Sweden. The variation in productivity is tested on the basis of various explanatory factors using multiple regression analysis according to OLS. The regression models used were a linear function, an exponential function of the Cobb-Douglas type as well as a transcendental function of the type first formulated by Reinhardt in 1972. The results show that the high productivity clinic is smaller (1-2 dentists), has a larger staff of assistants, has fewer children and adolescents among its patients and shows higher productivity also in the case of the other productivity measure.The study also contains an estimation of the production function for the 144 clinics. A Cobb-Douglas production function is used as a regression mode. The results point to significant estimated coefficient values for all production factors. The coefficient values are, as could be expected, positive and between zero and one in size. The results are in agreement with most of the estimations obtained from previous studies.