0888 The Exercise of Choice in Prosthodontic Care
I. POLZER1, J. DURHAM2, C. EXLEY3, T. MUNDT1, R. BIFFAR1, and N. JEPSON2, 1Greifswald University, Greifswald, Germany, 2Newcastle University, Newcastle, United Kingdom, 3Institute of Health and Society, Newcastle University, Newcastle, United Kingdom

OBJECTIVES: The aim of this study was to identify factors that influence General Dental Practitioners (GDPs) in their decision-making in prosthodontic care.

METHODS: This was a qualitative study that purposively sampled GDPs in the North of England. In depth interviews were conducted with 18 participants. Data collection and analysis occurred concurrently until data saturation was achieved (Glaser 1965, Strauss 1987). The transcribed interview data was analysed utilising a framework (Ritchie, Spencer and O'Connor 2007).

RESULTS: Simple removable prostheses were standard care in UK general dental practice. The major repeated determinants of treatment decisions were: preferences of patients - who were perceived as being unlikely to be willing to pay for dental prostheses; and a lack of adequate remuneration for time-consuming and expensive replacements, such as metal-based prostheses. Treatment options were discussed but these were framed by the GDPs' assumptions as to what the patient would want, or could afford. Confidence with familiar techniques and a lack of training with respect to other treatment options were also stated as strong influencing factors. Thus, cases of complex fixed prostheses were referred to centres of Secondary Care.

CONCLUSION: Administrative and financial restrictions of the Health Service seemed to have an impact on prosthodontic care. GDPs' treatment decisions may consciously or subconsciously be affected by the health care system. There seemed to be a need to review dentists' contracts to allow them to offer a fuller range of prosthetics in Primary Care Dental Service.

ACKNOWLEDGMENT: This study was funded by the Alfried Krupp von Bohlen and Halbach Foundation and the Community Medicine Research net (CMR) of the Greifswald University, Germany.

Seq #92 - Epidemiology and Health Services Research
2:00 PM-4:00 PM, Friday, September 12, 2008 Queen Elizabeth II Conference Centre Theatre H

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