Círculo Odontológico de Formosa: nos preocupa el impacto de los costos en la rentabilidad profesional / Dental Cyrcle of Formosa: we are concerned about the impact of costs on professional rentability

O Círculo Dental Formosa (COF) tem 295 membros que se juntam voluntariamente. . Dr. Silvia Naser, presidente da organização, enfatiza: "Precisamos associar colegas a trabalhar com as diversas obras sociais." Por outro lado, o círculo tem a sua própria clínica dentária localizada no último andar de sua sede: "Entre os nossos projetos, vamos fazer melhorias nos edifícios da clínica, a fim de proporcionar comodidade aos colegas". Outra iniciativa este ano é a criação de uma biblioteca para consulta pelos membros.

Charges for oral health care during a period of economic growth in the US: 1987-96.

OBJECTIVES: This study aimed to provide estimates of amounts charged for dental care during 1996 for the US adult population and its major sociodemographic subgroups, and to evaluate whether charges had increased since 1987. METHODS: We used data from the 1996 Medical Expenditures Panel Survey and report results for 12,931 adults aged 19-64 years. For comparison with previously published charges, we converted 1987 charges to their 1996 "constant dollar" value to control for inflation. Data were analyzed using SUDAAN and the results can be generalized to the US adult population. RESULTS: In 1996, 43.7 percent (95% CI=42.7%, 44.6%) of the US population incurred dental care charges, which did not differ significantly from the 1987 estimate of 44.5 percent. In 1996, mean per capita charge for dental care was 182 dollars (95% CI=171 dollars, 192 dollars), which did not differ significantly from the inflation-adjusted 1987 estimate of 174 dollars. The average charge per patient who incurred charges in 1996 was 416 dollars (95% CI=394 dollars, 438 dollars), which was only 7 percent greater than the inflation-adjusted 1987 estimate of 389 dollars (P=.08). Sociodemographic variations were observed in per capita charges, but were less apparent in mean charge per patient who incurred charges. CONCLUSIONS: During a period when economic growth and other market forces were expected to increase delivery of dental services, there was little or no change in percentage of US adults incurring charges or in mean per capita charges. The booming US economy did not raise dental charges significantly and did not increase utilization of dental care services.

Tiempos difíciles, tiempos de oportunidad / Hard times, times of opportunity

La educación formal del cirujano dentista no considera la capacitación en la parte operativa de la profesión, de tal forma, los aspectos organizacionales, administrativos, laborales y legales de la misma son aprendidos y desarrollados empíricamente. Lo anterior es desventajoso, pues implica pérdida de tiempo y un desarrollo económico a menor velocidad que la deseada. Los dentistas jóvenes a punto de iniciar su práctica o que recientemente la han iniciado, están en envidiable posición para capacitarse e introducir desde el inicio los aspectos empresariales que definen la práctica directa de la odontología, reconociendo que el consultorio dental es una empresa qie, sin importar su tamaño, requiere de organización, estrategias de mercado, definición de imagen, cálculo y fijación de costos y precios, además de relaciones hacendarias, ambientales y laborales sanas. En las siguientes páginas, los autores ofrecen algunas estrategias que ayudarán al dentista novel a establecer sus objetivos empresariales y al profesional establecido a reconocer sus cualidades y características para mejor orientar y estructurar los objetivos empresariales, y convertirla en una organización más eficiente y productiva, cimentando su presencia y asegurando su persistencia en el ambiente presente de globalización y constantes cambios y adaptaciones. En este artículo se ofrece además una serie de consejos prácticos que pueden dar excelentes resultados, mientras usted decide si ocurre un cambio organizacional mayor en su empresa

Censo de los empíricos en odontología radicados en Montería. Impacto de la Ley 100 sobre su ejercicio e identificación de sus características educativas y socioeconómicas / Census of the empiric dentists living in Monteria. The impact of the law 100 on their practice and identification of their educational and socioeconomic characteristics

Los empíricos en odontología radicados en Montería fueron censados para conocer el impacto de la Ley 100 sobre su ejercicio, identificar sus características educativas, socioeconómicas y personales. Los parámetros del censo, por empadronamiento directo, fueron: simultaneidad, territorio definido y universalidad. El empadronamiento y la recolección de la información se realizaron por medio de una encuesta estructurada, y su análisis, en Excel 3.5. 32 empíricos fueron censados, de los cuales 5 no fueron localizados y otros 5 no cumplieron con los criterios de inclusión, por lo que el análisis de la información se realizó en base a 22 personas. Se encontró que cada 4,7 años ingresa un empírico a la ciudad, su promedio de edad es de 47 años y llevan unos 26 años de ejercicio profesional. El estudio también reveló que los empíricos tienen un bajo nivel de escolaridad; que han sido formados en su mayoría por un odontólogo u otro empírico y el número de pacientes disminuyó como consecuencia de la Ley 100, generando inestabilidad económica y laboral

[Calculating dental fees--a 1988-1999 trend analysis]. / Zum Bemessungssatz zahnärztlicher Gebühren--eine Trendanalyse 1988-1999.

German GOZ (Gebührenordnung für Zahnärzte, catalogue of dental services) allows multipliers within a range from 1.0 to 3.5 for each fee, and it also prescribes medical arguments if dentists want to justify multipliers beyond 2.3. The authors analyze formal and material developments in these medical arguments of more than 3500 invoices from 1988 to 1999. Since 1988--amendment of GOZ--a development can be seen away from more general and patient-focussed towards arguments dealing with new dental materials and new forms of dental treatment. The authors analyse the way dentists (private ones and dentists of health insurance system), orthodontists, maxillo-facial- and oral surgeons charge their fees.

The effects of fee bundling on dental utilization.

OBJECTIVE: To examine dental utilization following an adjustment to the provincial fee schedule in which preventive maintenance (recall) services were bundled at lower fees. DATA SOURCES/STUDY SETTING: Blue Cross dental insurance claims for claimants associated with four major Ontario employers using a common insurance plan over the period 1987-1990. STUDY DESIGN: This before-and-after design analyzes the dental claims experience over a four-year period for 4,455 individuals 18 years of age and older one year prior to the bundling of services, one year concurrent with the change, and two years after the introduction of bundling. The dependent variable is the annual adjusted payment per user. DATA COLLECTION/EXTRACTION METHODS: The analysis was based on all claims submitted by adult users for services received at recall visits and who reported at least one visit of this type between 1987 and 1990. In these data, 26,177 services were provided by 1,214 dentists and represent 41 percent of all adult service claims submitted over the four years of observation. PRINCIPAL FINDINGS: Real per capita payment for adult recall services decreased by 0.3 percent in the year bundling was implemented (1988), but by the end of the study period such payments had increased 4.8 percent relative to pre-bundling levels. Multiple regression analysis assessed the role of patient and provider variables in the upward trend of per capita payments. The following variables were significant in explaining 37 percent of the variation in utilization over the period of observation: subscriber employment location; ever having received periodontal scaling or ever having received restorative services; regular user; dentist's school of graduation; and interactions involving year, service type, and regular user status. CONCLUSIONS: The volume and intensity of services received by adult patients increased when fee constraints were imposed on dentists. Future efforts to contain dental expenditures through fee schedule design will need to take this into consideration. Issues for future dental services research include provider billing practices, utilization among frequent attenders, and outcomes evaluation particularly with regard to periodontal care and replacement of restorations.