Age, period and cohort analysis of patient dental visits in Australia

BMC Health Services Research

A John Spencer¹  David S Brennan¹  Xiangqun Ju¹ 

[1] Australian Research Centre for Population Oral Health, The University of Adelaide, South Australia 5005, Australia

关键词: Patient visits;    Cohort;    Period;    Age;   

Others  :  1134346
DOI  :  10.1186/1472-6963-14-13

 received in 2013-07-04, accepted in 2013-12-20,  发布年份 2014

【 摘 要 】

Background

Understanding dentists’ capacity to supply dental services over time is a key element in the process of planning for the future. The aim was to identify time trends and estimate age, period and cohort effects in patients’ visits supplied per dentist per year.

Methods

Mailed questionnaires were collected from a random sample of Australian private general practice dentists. The response rates were 73%, 75%, 74%, 71%, 76% and 67% in 1983, 1988, 1993, 1998, 2003 and 2009, respectively. The time trends in the mean number of patient visits supplied per dentist per year (PPY) was described by using a standard cohort table and age-period-cohort analyses applying a nested general linear regression models approach.

Results

The mean number of PPY decreased across most age groups of dentists over the time of study. The age-period model showed that younger dentists (20–29 years) and older dentists (65–74 and 80–84 years) had lower PPY than middle-aged dentists, and the age-cohort model showed higher PPY among earlier cohorts, and lower PPY among more recent cohorts.

Conclusion

The study found a period effect of declining PPY over the observation period. More recent cohorts of dentists provide lower numbers of PPY than earlier cohorts at similar ages, but the provision of PPY among these younger cohorts appeared to be stable as they moved into middle age.

【 授权许可】

   
2014 Ju et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Brennan DS, Spencer AJ: Trends in service provision among Australian private general dental practitioners over a 20-year period. Int Dent J 2006, 56:215-223.
• [2]Spencer AJ, Brennan DS, Szuster FSP: Trends in work effort among private general dental practitioners. Int Dent J 1994, 44:223-229.
• [3]Chrisopoulos S, Nguyen T: Trends in the Australian dental labour force, 2000 to 2009: dental labour force collection, 2009. Australian Institute of Health and Welfare: Canberra; 2012.
• [4]Brennan DS, Spencer AJ: Practice activity trends among Australian private general dental practitioners: 1983–84 to 1998–99. Int Dent J 2002, 52:61-66.
• [5]Bravo M: Age-period-cohort analysis of dentist use in Spain from 1987 to 1997: an analysis based on the Spanish National Health Interview Surveys. Eur J Oral Sci 2001, 109:149-154.
• [6]Brennan DS, Ryan P, Spencer AJ, et al.: Dental service rates: age, period, and cohort effects. Community Dent Health 2000, 17:70-78.
• [7]Clayton D, Schifflers E: Models for temporal variation in cancer rates. II: age-period-cohort models. Stat Med 1987, 6:469-481.
• [8]Spencer AJ, Szuster FSP, Brennan DS: Service-mix provided to patients in Australian private practice. Aust Dent J 1994, 39:316-320.
• [9]Brennan DS, Spencer AJ, Szuster FSP: Service provision trends between 1983–84 and 1993–94 in Australian private general practice. Aust Dent J 1998, 43:331-336.
• [10]Brennan DS, Spencer AJ: Service provision trends among Australian private general dental practitioners: 1983/84 to 1998/99. Int Dent J 2003, 53:145-152.
• [11]Polissar L, Diehr P: Regression analysis in health services research: the use of dummy variables. Med Care 1982, 20:959-966.
• [12]Clayton D, Schifflers E: Models for temporal variation in cancer rates. I: age-period-cohort models. Stat Med 1987, 6:469-481.
• [13]Teusner DN, Spencer AJ: Dental labour force, Australia 2000. Australian Institute of Health & Welfare: Canberra; 2003.
• [14]McKay JC, Quinonez CR: The feminization of dentistry: implications for the profession. J Can Dent Assoc 2012, 78:1-7.
• [15]Solomon ES: The future of Dentistry. http://www.dentaleconomics.com/articles/print/volume-95/issue-2/features/the-future-of-dentistry.html webcite
• [16]Brennan DS, Spencer AJ, Szuster FSP: Differences in time devoted to practice by male and female dentists. Br Dent J 1992, 172:348-349.
• [17]Brennan DS, Balasubramanian M, Spencer AJ: Practice profiles of male and female dentists in Australia. Aust Dent J 2011, 56:97-99.
• [18]Ayers KM, Thomson WM, Rich AM, et al.: Gender differences in dentists’ working practices and job satisfaction. J Dent 2008, 36:343-350.
• [19]Spencer AJ: Putting the population back into oral health; decoupling oral health improvement from clinical dental practice. Community Dent Oral Epidemiol 2012, 40(Suppl 2):5-11.
• [20]Brennan DS, Spencer AJ, Szuster FSP: Service provision patterns by main diagnoses and characteristics of patients. Community Dent Oral Epidemiol 2000, 28:225-233.
• [21]Brennan DS, Spencer AJ, Szuster FSP: Insurance status and provision of dental services in Australian private general practice. Community Dent Oral Epidemiol 1997, 25:423-428.
• [22]NACOH: Healthy mouths healthy lives: Australia’s National Oral Health Plan 2004–2013. Adelaide: National Advisory Committee on Oral Health, Australian Health Ministers’ Advisory Council; 2004.
• [23]National Advisory Council on Dental Health: Report of the National Advisory Council on Dental Health. Canberra: Department of Health and Ageing; 2012.
• [24]Mason J: Review of Australian Government Health Workforce Programs. Canberra: Department of Health and Ageing; 2013.
• [25]ARCPOH: Dental labour force projections 2005 to 2020: the impact of new regional dental schools. Aust Dent J 2008, 53:292-296.
• [26]Health Workforce Australia: Health Workforce 2025 - Oral Health, Background Paper. Adelaide: Health Workforce Australia; 2013.