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Treatment intensity and provider remuneration: dentists in the British National Health Service

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  • Martin Chalkley
  • Colin Tilley

Abstract

Dental service providers in the British National Health Service (NHS) operate under a number of remuneration arrangements that give rise to different incentives. Using data derived from the Scottish dental system, we examine the relationships between remuneration, patient exemption status and treatment intensity. After controlling for differences in patient need and dentist‐specific preferences, we find that self‐employed dentists treat patients who are exempt from payment more intensively than their salaried counterparts. The results imply that changes in remuneration can have a large effect on the distribution of treatments. More generally, our results provide support for economic models that view financial incentives as important determinants of physician behaviour. Copyright © 2006 John Wiley & Sons, Ltd.

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  • Martin Chalkley & Colin Tilley, 2006. "Treatment intensity and provider remuneration: dentists in the British National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 933-946, September.
    • Handle: RePEc:wly:hlthec:v:15:y:2006:i:9:p:933-946
    DOI: 10.1002/hec.1162
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    Cited by:

    1. Olivier Kalmus & Martin Chalkley & Stefan Listl, 2022. "Effects of provider incentives on dental X-raying in NHS Scotland: what happens if patients switch providers?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 59-65, February.
    2. Listl, Stefan & Chalkley, Martin, 2014. "Provider payment bares teeth: Dentist reimbursement and the use of check-up examinations," Social Science & Medicine, Elsevier, vol. 111(C), pages 110-116.
    3. Harris, Rebecca V. & Sun, Ningwei, 2012. "Translation of remuneration arrangements into incentives to delegate to English dental therapists," Health Policy, Elsevier, vol. 104(3), pages 253-259.
    4. Martin Chalkley & Colin Tilley & Linda Young & Debbie Bonnetti & Jan Clarkson, 2008. "The Effect of Activity-Based Payment on Dentists’ Activity: Evidence from a Natural Experiment in the UK National Health Service," Dundee Discussion Papers in Economics 217, Economic Studies, University of Dundee.
    5. Chalkley, Martin & Wang, Shaolin & Tilley, Colin, 2011. "Comparing the treatment provided by migrant and nonmigrant health professionals: dentists in Scotland," SIRE Discussion Papers 2011-01, Scottish Institute for Research in Economics (SIRE).
    6. Jones, A.M, 2010. "Models For Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 10/01, HEDG, c/o Department of Economics, University of York.
    7. Nolan, Anne, 2019. "Reforming the delivery of public dental services in Ireland: potential cost implications," Research Series, Economic and Social Research Institute (ESRI), number RS80.
    8. Anthony Scott & Stefanie Schurer & Paul H. Jensen & Peter Sivey, 2008. "The Effect of Financial Incentives on Quality of Care: The Case of Diabetes," Melbourne Institute Working Paper Series wp2008n12, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    9. Martin Chalkley & Stefan Listl, 2017. "First do no harm – The impact of financial incentives on dental x-rays," Working Papers 143cherp, Centre for Health Economics, University of York.
    10. Chalkley, Martin & Listl, Stefan, 2018. "First do no harm – The impact of financial incentives on dental X-rays," Journal of Health Economics, Elsevier, vol. 58(C), pages 1-9.
    11. Marton, James & Yelowitz, Aaron & Talbert, Jeffery C., 2014. "A tale of two cities? The heterogeneous impact of medicaid managed care," Journal of Health Economics, Elsevier, vol. 36(C), pages 47-68.
    12. Bonnetti, Debbie & Chalkley, Martin & Clarkson, Jan & Tilley, Colin & Young, Linda, 2008. "The Effect of Activity-Based Payment on Dentists’ Activity: Evidence from a Natural Experiment in the UK National Health Service," SIRE Discussion Papers 2008-45, Scottish Institute for Research in Economics (SIRE).

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