Implementation of altered provider incentives for a more individual‐risk‐based assignment of dental recall intervals: evidence from a health systems reform in Denmark

Equipping health systems with suitable incentives for efficient resource allocation remains a major health policy challenge. This study examines the impacts of 2015 regulatory changes in Danish dental care which aimed at effectuating a transition from six‐to‐twelve‐monthly dental recall intervals, for every patient, towards a model where patients with higher need receive dental recalls systematically more frequently than patients with lower need. Exploiting administrative data from the years 2012‐2016 from the Danish National Health Insurance database containing 72,155,539 treatment claims for 3,759,721 unique patients, we estimated a series of interrupted time‐series regression models with patient‐level fixed‐effects. In comparison to the pre‐reform period, the proportion of patients with recall intervals of up to 6 months was by 1.2%‐points larger post‐implementation; that of patients with 6‐12‐monthly recalls increased by 0.7%‐points; that of patients with more than 12‐monthly dental recalls decreased by 1.9%‐points. The composition of care shifted more substantially: the proportion of treatment sessions including preventive care increased by 31.5%‐points (95%‐CI: 31.4;31.6); that of sessions including scaling increased by 24.1%‐points (24.0;24.2); that of sessions including diagnostics decreased by 34.5%‐points (34.4;34.6). These findings suggest that dental care providers may have responded differently to regulatory changes than intended by the health policy.