Alberta's universal dental plan for the elderly: Differences in use over 6 years by two cohorts

Objectives. Dental services use by two cohorts under the universal dental plan for the elderly in Alberta, Canada, was examined. Methods. Two birth cohorts 65 to 69 years old at entry who used the plan from 1978 to 1979 (n = 17 816) or from 1985 to 1986 (n = 27 474) were analyzed over 6 successive years for differences in dental services use and costs. Results. The 1985/86 cohort received 24% more visits per patient than the 1978/79 cohort. Their inflation-adjusted expenditures increased by 19% mainly as a result of increases in denturists' expenditures (33%) (dentists' expenditures increased just 4% because of lower plan fee increases). The 1985/86 cohort received relatively many more periodontal and fewer denture services. Annual attendance over 6 consecutive years was high, especially for the 1985/86 cohort and dentists' patients; 55% of the 1985/86 cohort who used dentists did so in 5 or all 6 years. Conclusions. Differences in plan expenditures per patient between the birth cohorts and dentists and denturists, along with the high continuity of care for dentists' patients, have important implications for planning and administering dental plans for the elderly. The large expenditure decreases for removable dentures and the large increases for periodontal services to the 1985/86 cohort are noteworthy.