The impact of changes in the new dental funding system on the mood of dentists

Abstract

The legislator introduced the group practices system of general practitioners in primary dental care with territorial service obligations (early 2021) and a quality indicator system in place of the capitation fee depending on the practice's size (January 2023). The latter was implemented without a pilot program or substantial testing. These changes were introduced unexpectedly and appear to be unfair from several perspectives.

We aim to examine the impact of the ongoing transformation processes (the establishment of collaborative work of general practitioners and the introduction of the indicator system) on the primary dental healthcare system. This is done by measuring mood-reflecting elements (willingness to transfer the dental career, ethical distress) among dentists.

We conducted surveys online and anonymously at four different times: April 2022, May 2023, February 2024, and October 2024, to gather opinions from affected dentists on the collaborative work and funding based on indicators. The questionnaires were continuously extended with questions reflecting the current situation.

Our results indicate that the unprepared introduction of the quality indicator system destroyed the previously slightly optimistic mood due to the collaborative work system. While the collaborative work system is somewhat discriminatory, it may also have a protective effect through funding and collegial relationships.