ASSESMENT OF THE SOCIAL EFFECTIVENESS OF THERAPEUTIC DENTAL SERVICES PROVIDED WITHIN THE SOCIAL HEALTH INSURANCE FRAMEWORK

ABSTRACT

Research Objectives: Assessment of the quality of free dental care provided to the public.

Research material and methodology: Results of analysis of patients’ survey. Informational-analytical methods, analytical, statistical, sociological, bibliographic methods were used in the research.

Results: 300 patients participated in the survey about free dental care.  201 (67%) of those surveyed were women, 99 - (33%) were men. According to 207 (69.3%) respondents, dental care within the framework is effective and efficient. However, 93(30.7%) consider the services to be ineffective in treating dental diseases.  45.6% of respondents consider free dental care ineffective due to outdated material and equipment. 70% of the patients surveyed said they were aware of provision of free dental care. The major percentage of the respondents, that is, two thirds knew about the existence of free dental care in Kazakhstan. Whereas 90 respondents (30 per cent) were unaware of free dental care provided by the state.

Our findings indicate that we have identified weaknesses in the provided system of free dental care through a patient survey.

Discussion: The conducted analysis revealed the following findings regarding patient satisfaction with free dental care services.

1.There is a low level of awareness among patients of the existence of free dental care as 90 out of 300 respondents were not aware of the existence of free dental care.

2.45.6% of respondents indicated that there is a lack of appropriate approach to children by dentists.

3.Early diagnosis and primary preventive treatment can reduce the prevalence of dental and mouth abnormalities.

Conclusion: Practical recommendations were developed after analyzing data from the survey of patients who utilized free dental services within private clinics, with an aim to improve the quality of dental services.  Improvement of service quality leads to increased number of customers, in turn increasing the level of dental health of population of Kazakhstan.

Keywords: Social efficiency, free dental care.

Introduction:

Dental services provided to the population in our country have become one of the first in the context of market relations. As a result of the transition to a market economy, more and more private dental services have emerged as an alternative to the public sector.  In connection with this, the population of our country has been given the opportunity to freely choose not only between dental services, but also a doctor, the form of payment, and etc. Despite this, numerous studies show an increase in the prevalence of dental diseases among the population of the Republic of Kazakhstan.

The organization of dental care for adults in the framework of OSHI in medical organizations is carried out free of charge in accordance with the Decree of the Government of the Republic of Kazakhstan of 16 October 2020 No672, Standard organization of dental care in the Republic of Kazakhstan (Approved by the Order of the Minister of Health and Social Development of the Republic of Kazakhstan of December 12, 2016 No1053) Dental care for adults and children includes the provision of preventive, diagnostic and therapeutic measures in accordance with established standards of medical care, on the basis of clinical protocols of diagnosis and treatment of the Ministry of Health of Kazakhstan [1]

As of 2019, there are 1,817 dental organizations in the Republic of Kazakhstan, 596 of which (33 per cent) are State owned and 1,221 have private ownership (67 per cent). [3] The evaluation of the organization and provision of free dental care within the OSHI has been the subject of our research. The limited availability of dental services to the public results in patients' dissatisfaction with the health care system. [2]

Research objective: Assessment of the quality of free dental care provided to the public.

Research material and methodology: The prospective study involved 300 respondents aged between 18 and 63, as well as parents of children under 18. The online survey was conducted anonymously through the Google platform. Prior to the survey, all respondents signed an informed consent paper. A questionnaire was developed to examine the opinion of patients who received free dental care. The questionnaire contains 10 questions to assess the organizational issues of free dental care. In our study, the statistical analysis of the received data included the determination of the Students’ t-criterion. In statistical processing, the differences were considered valid at p<0.05.

Research results:

A questionnaire was developed to examine the opinion of patients who received dental care. The questionnaire takes into account the features of the provision of dental care and allows to assess the main parameters of availability and quality of medical dental care. The responses to the questions were examined and analysed, description and analysis of the data is reflected in the following sections. The sample size guaranteed the validity of the results in our study at least 95% of the cases. This level of confidence is t= 4%.

In our study, the statistical processing of the received data included the determination of the Students t-value. In statistical processing, the differences were considered statistically valid for p<0.05.300 respondents participated in the survey. The results of the survey are given in the descriptive statistics of the patients survey of free dental care. At the time of interviewing respondents -201 (67%) were women, 99 - (33%) men. 70% of the patients surveyed said they were aware of free dental care. The main percentage, that is, two thirds knew about free dental care. Of these, 90 (30 per cent) were unaware of free dental care.73.3% of respondents indicated that during their clinical visit, the faced a waiting period of up to 20 minutes, 20% - up to 30 minutes, 6.7% more than 1 hour. As a result, the research revealed that the organizational part of the appointment waiting for a dentist is not a significant problem. According to 207 (69.3%) of the patients surveyed, dental care within the framework is effective. However 93(30.7%) - consider the service not effective for treatment of dental diseases. 45.6% of respondents consider free dental care ineffective due to outdated material and technical equipment.

The study asked respondents to assess both the quality of health services and the level of organization of the treatment and diagnostic process. Use of old and outdated dental equipment, application of therapeutic treatment of filling materials made of chemical curing.  It is also worth noting that sometimes patients have encountered inadequate attention from the dentist towards young children 12% (36). In general, there isa positive trend. However, the negative aspect, which is the insufficient treatment for children may be related to the wrong organizational aspect of the dentistry work.22.4% (67) of respondents have been unable to receive full dental care, as free dental care includes only therapeutic and surgical care. Other treatments are not included in the free dental care program.169 respondents rated the quality of dental care by 5 points out of 5, 46 respondents rated 4 points, 72 respondents rated with 3, 2 points had 0 votes, 1 point rating from 10 patients and, 0 points from 0 respondents.

Discussion

The analysis showed the following results regarding patient satisfaction with free dental service.

Firstly, there is a low level of awareness among patients about the existence of free dental care as 90 out of 300 respondents were not aware of the existence of free dental care.

73% (219) of respondents consider free dental care effective, the remaining 27% (81) think otherwise. This suggests that more than half of patients were satisfied with both the organization and medical care provided within the framework. Twenty percent of those surveyed had a big queue to get the appointment with a dentist, indicating a downside to the availability of dental care.

Secondly, 45.6 per cent of respondents indicated a lack of proper approach and treatment towards children by doctors, it can be said that dentists should regularly improve their social skill in communicating with young patients.

Third, the fact that free dental care includes emergency and planned only surgical and therapeutic treatment, leads to other finding. As previously identified, an increase in the prevalence of dental and oral anomalies in patients, indicates a need for orthodontic, orthopaedic care as well. The cost of treating dental and oral abnormalities in private clinics is currently expensive, because of these many consumers cannot afford dental healthcare. Early diagnosis and primary prophylaxis can reduce the prevalence of such dental and oral diseases.

Conclusion

The pursuit of new and effective technologies for treatment and prevention should be a key factor in improving the quality of dental care.  In the last 30 years dentistry has made a profound technological breakthrough, especially in the area of caries and prevention, allowing to dramatically increase the effectiveness of dental care. According to the questionnaire, it was found that the treatment of dental diseases is still using filling materials of chemical curing, which, in turn, are not effective. Today there are appropriate modern technologies for sealing materials utilizing light curing. Patients noted the lack of appropriate approach to young children by dentists. This situation is also very important. By careful approach to children, it is possible in the future to encourage young children to go more and more without fearing dental professionals and to take care of their dental health. It is also necessary to take into account external factors, the change of which is outside the competence of the medical organization itself. The low level of education of the population must be addressed at the level of school and school organization.

The social survey involved 300 patients from frequent dental clinics providing free dental care. The questionnaire consisted of 10 questions aimed at assessing the quality of dental care contributing to the further improvement of the services provided.

Our findings indicate that we have identified weaknesses in free dental care through patient survey. With this, practical recommendations were developed to improve the quality of free dental assistance to the population.

Positive results are also the discovery of a high level of patient satisfaction, indicating that free dental care is provided to the population according to adequate standards. To date, free dental care for the population has become even more accessible as, according to the Foundation, access to a medical organization for dental care does not require referral from polyclinics either. It is essential that the patient is included in one of the categories of recipients of free dental care and has a medical indication. Every patient can easily access free dental clinics. The list of suppliers of free dental care is listed on the website fms.kz.

On the basis of this, it can be concluded that 69.3% of the respondents were satisfied with the quality of free dental care. This indicates that there is a need to further improve and strengthen existing mechanisms to improve the quality of free dental care in the country. The identification of factors and the development of practical recommendations contribute to reducing the prevalence of caries and other dental diseases in children and adults.

References:

1. Sembayev A.B. 2013 O profilaktike, lechenii stomatologicheskoj zabolevaemosti naselenija Atyrauskoj oblasti [Abaut preventive and treatment dental disease in Atyrau region]. Vestnik KazNMU; [https://kaznmu.edu.kz/press/2013/09/25/о-профилактике-лечении-стоматологич/]
2. Code of the Republic of Kazakhstan. On the health of the people and the healthcare system: dated September 18, 2009 N31-VI HCRK [https://adilet.zan.kz/rus/docs/V1600014664]