Dental Care Utilization After the Implementation of “Health Reform Plan” in Isfahan Province

Health reform plan in dentistry has been implemented systematically in Iran since 2014 in villages and cities with a population lower than 20,000 inhabitants. This study aimed to evaluate the impact of this plan on the utilization of dental services in Isfahan province.

Ten health centers with dentists contracted with the health reform plan were recruited. The frequency of dental services (examination, preventive care, restorative care, and extraction) was assessed. Four centers not in contract with this plan were considered as the control centers. To compare the frequency of provided services, the non-parametric tests of Mann-Whitney and Wilcoxon (α=0.05) were used (SPSS 22).

In the control centers, the cumulative frequency of provided care demonstrated no significant difference between 2014 and 2017. In the centers subject to the reform plan, there were increases in examination (p=0.02), amalgam (p=0.04), and composite restoration (p=0.04) in the age group of 6 years, and examination, extraction, amalgam, and composite restoration (p=0.007) in the age group of 6-12 years. In pregnant women, extraction (p=0.017), composite restoration (p=0.04), and scaling (p=0.012) increased significantly. In the six-year-old group, the means difference of extraction (p=0.036) and amalgam restoration services (p=0.024) and in the age group of 6-12 years, the means of extraction (p=0.014) and amalgam restoration (p=0.008) were significantly increased in the centers subject to the reform plan than in the control group.

After the implementation of the reform plan in health centers, dentists were more willing to provide preventive and restorative care that could be partially due to financial incentives.