1. Dental planning information:
more than a body count
X i^ ^ u e s tio n s re la ted to p la n n in g fo r th e
size, n a tu re , and d is trib u tio n o f d en ta l m a n
p o w e r are d iffic u lt to address to d a y. A n sw ers,
h o w e v e r, are essential. D e n ta l m a n p o w e r p la n
nin g d ire c tly relates to p ro po sals fo r n ational
h ealth p ro g ram s, d e te rm in a tio n o f sh ortage
areas, c o o p e ra tio n w ith h ealth system s a g en
cies, and th e n e e d to e x p a n d o r c o n trac t th e
den tal au xiliary e d u c a tio n system s.
In 1973, th e A m eric an D e n tal A ssociation
began a search fo r tools th a t w o u ld be su ffi
c ie n tly sensitive a n d c o m p re h e n s iv e to p ro v id e
th e necessary in fo rm a tio n fo r m a kin g in fo rm e d
c o m m e n t on d en tal m a n p o w e r q u e stio n s. T h e
w o rk acco m p lish e d by o u ts id e agencies and As
sociation staff has resu lte d in th e d e v e lo p m e n t
o f th e D e n ta l P lanning In fo rm a tio n System
(D P IS ).
DPIS is a w e ll-c a lib ra te d to o l to p ro v id e a d e
scrip tio n o f th e p res en t an d reas o n ab le p ro je c
tio n s fo r th e fu tu re , b u t it is n o t an "a n s w e r m a
c h in e ." It c a n n o t su b stitu te c o m p u te r calcu la
tio n fo r h um an ju d g m e n t. T h e q u a lity o f its p e r
fo rm a n c e d e p e n d s d ire c tly on k n o w le d g e , o b
jec tiv ity , and th e ab ility to ask th e rig ht q u e stio n
in th e rig h t w ay.
T h e basic p rem is e o f th e system is to m o ve
d en tal m a n p o w e r p la n n in g o u t o f th e lab o rato ry
and into th e real w o rld w h e re th e " h u m a n "
eq u a tio n s can b e s tu d ie d . A lth o u g h th e system
has n o t ye t re ac h e d its fu ll ca p a b ility , intensive
fie ld w o rk in 21 states, an d th e c o o p e ra tio n o f
dentists in th o se states, is alread y p e rm ittin g
fu rth e r re fin e m e n t.
T h e system deals w ith th re e m atters: th e
existing and p ro je c te d fu tu re n u m b e r o f d e n
tists; th e p ro d u c tiv ity , in te rm s o f services to
p a tien ts, th a t is d e riv e d fro m a p p ro p ria te c o o p
eratio n b e tw e e n d en tists, h ygienists, and assis
tants; an d th e u tiliza tio n o f d en tal services,
b o th n o w and in th e fu tu re .
A p ro d u c tiv ity e q u a tio n , d e scrib in g th e w o rld
o f th e d en tal o ffic e , is co m p o se d o f factors such
as th e pace at w h ic h persons m ay w o rk ; this
d e p e n d s , in p a rt, on th e levels at w h ic h d u ties
are d ele g ate d to various types o f d en ta l p e rs o n
n el. A u tiliza tio n e q u a tio n d escrib in g d en ta l
care co n su m ers is c o m p o se d o f factors such as
th e ratés at w h ic h p e o p le seek d en tal care;
th ese d e p e n d , in p a rt, on th e ir e d u c a tio n , ag e,
sex, race, an d in c o m e . T h e c o m p le x ity o f th ese
e q u atio n s sh o u ld n o t be disposed o f by "g ue ss
tim a te s" in th e la b o ra to ry , b u t e x a m in e d th o r
o u g h ly w ith data an d statistical to ols.
SOME USEFUL DEFINITIONS
r
WITH EXAMPLES
■
o r an u n d e rsta n d in g o f th e system and its
use, a fe w d e fin itio n s are h e lp fu l:
P r o d u c tiv ity , in DPIS term s , is th e o u tp u t o f
d en tal care services p e r u n it o f m a n p o w e r
m eas u red o v e r a p e rio d o f tim e .
S u p p ly is th e sum o f th e o u tp u t p ro d u c e d by
each m a n p o w e r u n it o ve r th a t tim e p e rio d .
N e e d fo r d en tal care is d e fin e d by th e seg
m e n t o f th e p o p u la tio n su fferin g fro m o n e o r
m o re d en tal diseases. S o m e persons in this
s e g m en t, h o w e v e r, d o n o t rea lize th a t th e y are
in n eed o f d en ta l care.
D e m a n d refers to th o s e persons re a lizin g a
need and also to th e q u a n tity o f d en tal care
services th e y are w illin g to o b tain at various
prices.
E ffe c tiv e d e m a n d (u tiliza tio n ) deals w ith
translating p e rc e iv e d need and w illin g ness in to
a c tio n : th e u tiliza tio n o f th e d en tal d e liv e ry sys
te m .
T h e n u m b e r o f visits p ro vid e d by a d e n tis t in a
ye ar is o n e m easure o f th a t d en tis t's p ro d u c tiv
ity. In this case, su p ply is th e total n u m b e r o f
visits p ro v id e d by all dentists in an area (a
c o u n ty , fo r ex am p le) u n d e r study, in a ye ar. If
th e re is o n ly o n e d en tis t in a c o u n ty , th e
n u m b e r o f service visits represen ts th e d en tis t's
p ro d u ctiv ity as w e ll as th e supply fo r th a t
co u n ty .
776 ■ JADA, Vol. 96, May 1978
2. DEVELOPMENT OF THE DPIS
PRODUCTIVITY ANALYSIS
^ ■ a c h d en tis t can d e te rm in e th e a m o u n t
and kind o f d en tal services a p a tie n t o u g h t to
co n su m e to achieve a m in im a l, a c c e p ta b le , o r
o p tim a l level o f oral h ealth . T hat is, d entists can
im p lic itly d e te rm in e n eed fo r th o s e persons
u tilizin g th e d en tal d eliv e ry system . C o n sisten t
data on th e oral health status and n eeds o f all
p e o p le , h o w e v e r, are n o t av ailab le. T h e total
n u m b e r o f d en tal services actively b ein g
so u gh t— e ffe c tiv e d e m a n d — is o n e c o m p o n e n t
o f n eed .
By c o m b in in g state-level m a n p o w e r q u e s
tio n n a ires and th e p ro d u c tio n fu n c tio n 1 (a
te c h n o lo g ic a l re la tio n sh ip sh o w in g h o w inputs
are tra n s fo rm e d in to o u tp u ts ) d e v e lo p e d fro m
th e 1975 p ilo t surveys in In d ia n a , Louisiana, and
Pennsylvania, DPIS p ro vid e s a m e th o d o f as
sessing changes in th e u tiliza tio n o f d en tal p e r
so n n e l, d e n ta l o p e ra to rie s , and d en tists' p rac
tice e x p e rie n c e . For th e state d en tal societies
p a rticip atin g in th e system , assessm ents can be
m a d e on th e state level and substate levels, d e
p e n d in g o n th e g eo g rap h ic resp on se p attern to
th e surveys.
V a lu e o f w e ig h te d services (V W S ) is th e p ri
m ary o u tp u t m easure in D P IS . T h e first step in
d e v e lo p m e n t o f th e V W S m e as u re was th e as
s ig n m en t o f w eigh ts to various d en tal services,
via a system atic ex am in atio n o f th e m a jo rity of
services p ro v id e d in d e n tal o ffices. These
w eigh ts are called relative va lu e u n its .2 (R elative
va lu e units w e re assigned on th e basis of
k n o w le d g e — c o n te n t o f k n o w le d g e , u n d e r
standing and ju d g m e n t; skill— digital d e x te rity ,
e x p e rie n c e , and p e rc ep tu a l skill; e ffo rt—
physical e ffo rt, m ental e ffo rt, and visual e ffo rt,
and resp on sib ility— effe c t o f e rro r and c o rrec
tio n o f e rro r.)
A V W S calcu latio n is m a d e fo r each survey
re s p o n d e n t. T h e n u m b e r o f tim e s a re s p o n d e n t
p erfo rm s each p ro c e d u re is c o u n te d . (T h e re are
62 p ro c e d u re classifications in th e m a n p o w e r
q u e s tio n n a ire .) T hese p ro c e d u re counts are
th e n m u ltip lie d by th e c o rre s p o n d in g relative
v alu e units to o b ta in a V W S fo r each p ro c e d u re .
Finally, th e V W S s fo r a p ro c e d u re are a c c u m u
lated to o b ta in a m easure o f a den tist's o u tp u t in
term s o f v a lu e o f w e ig h te d services. For ex am
p le , if a d en tist w e re to p e rfo rm five
p ro ph ylaxes and th at service has b een assigned
a w e ig h t o f 15, th e n o u tp u t w o u ld be 75 V W S .
T h e calcu latio n of w e ig h te d services en ab les
th e system to m easure m o re than m e re v o lu m e
o f services. D iffe re n t d en tal services re q u ire d if
fe re n t levels o f skill, e ffo rt, and tim e to p e rfo rm .
By co n sid e rin g th ese d iffe re n c e s , a m o re
sophisticated m e as u re m e n t o f th e m ix o f ser
vices b e in g p ro v id e d can be a c h ie v ed . (The
n u m b e r o f p a tie n t visits, c o m m o n ly used fo r
m any years in m e a s u re m e n t o f services, is used
by DPIS as a seco n dary o u tp u t m eas u re.)
It m ay b e possible to id e n tify a h ost o f
factors-variables a ffe ctin g a den tist's p ro d u c tiv
ity. T w o issues, h o w e v e r, lim it th e variab les th at
can be used in th e p ro d u c tio n fu n c tio n ap
p ro ach . O n e is th e availab ility o f data: w ith o u t
data on a fac to r-v a riab le , q u a n tita tiv e analyses
are n ot possible. T h e second issue is statistical
re leva n ce: w ith o u t statistical rele van c y, a
fac to r-v a riab le m ay n ot p ro v id e a sig nifican t
c o n trib u tio n to th e d e sc rip tio n o f th e d en tal
care services p ro d u c tio n process.
T h e d ata source used in es tim atin g th e DPIS
p ro d u c tio n fu n c tio n stem s fro m th e p rev io u sly
m e n tio n e d p ilo t studies. A fte rth e resu ltan t data
had b ee n co m p ile d and a p p ro p ria te statistical
te c h n iq u e s a p p lie d , a set o f in p u t variables was
id e n tifie d as m ost rele van t in th e p ro d u c tio n o f
d en tal care services. These are a den tist's ch air-
side h o u rs , n u m b e r o f chairs used by th e d e n
tist, h ygienist's chairside h o u rs , d en tal assis
tant's ch airside h ou rs, ex p a n d e d d u ty assis
tant's ch airside h ou rs, th e n u m b e r o f years
since th e d en tis t g ra d u a te d , and th e p e rc e n t of
dentists w h o are in g ro u p p rac tice.
T w o types o f q uestions can be asked o f th e
system . O n e re qu es t w o u ld be a c u rre n t status
re p o rt th a t estim ates visits and v a lu e o f
w e ig h te d services. Such a re q u es t involves a
sim p le calcu latio n fro m d ata s u p p lie d on th e
den tists' q u e stio n n aires an d does n o t use th e
es tim ate d p ro d u c tio n fu n c tio n . S eco nd , a p ro
jec tio n can b e re qu es ted in w h ich th e v alu e o f
o n e o f th e selected variables in th e p ro d u c tio n
fu n c tio n is assum ed to ch an g e. For ex a m p le , an
assu m p tion can b e m ad e th a t assistants' c h a ir
side hours w ill increase by 10% . A c c o rd in g to
th e p ro d u c tio n e q u a tio n , this w ill increase d e n
tists' p ro d u c tiv ity a n d , h e n ce , increase th e sup
p ly o f d en ta l care services.
T h e p ro d u c tio n fu n c tio n reached in this w ay
also can b e used to d e v e lo p a p ro d u c tiv ity in
d ex. For e x a m p le , th e va lu e o f w e ig h te d ser
vices p ro d u c e d by d entists having o n e ch air and
no au xiliary assistance c o u ld be co n sid e re d as a
DENTAL MANPOWER PLANNING ■ 777
3. b ase lin e w ith a p ro d u c tiv ity in d ex o f 1.00— th e
base. From this base, th e increase in p ro d u c tiv
ity th a t can p o te n tia lly b e ac h ie ved th ro u g h d if
fe re n t p ractice c o n fig u ra tio n s (a d e n tis t w o rk
ing w ith o n e h yg ienist an d o n e assistant) can be
calcu lated an d expressed in th e fo rm o f an in
d ex. P re lim in ary p ro d u c tiv ity indexes are in th e
ca lcu latio n process.
This essentially is h o w th e supply side o f th e
DPIS is d e riv e d . W h ile p ro d u c tiv ity estim ates
are useful in and o f th em s e lv e s , th e o th e r side
o f th e co in — th e c o n s u m p tio n o f d en ta l care
services— is eq u a lly im p o rta n t.
DEVELOPMENT OF DPIS
T
UTILIZATION DATA
he calcu latio n o f ex p e cte d u tiliza tio n is
co m p lex . M o re o v e r, it is ex p e n sive , p erhaps
p ro h ib itiv e ly so, to am ass and co n tin u o u s ly u p
d ate d ata o n th e d e m a n d fo r services d u rin g th e
m o re th a n 330 m illio n vis its.3 T h e q u e stio n o f
d e m a n d relative to n e e d m u st b e c o n sid e re d as
w e ll.
T h e co n su m p tio n sid e o f d e n ta l care has
th re e c o m p o n e n ts : n e e d , p e rc e p tio n th a t need
exists, an d actio n by th e in d ivid u al to have th at
need m e t.
As stated p rev io u sly, th e overall n eed fo r d e n
tal services is d e fin e d by th a t s e g m en t o f th e
p o p u la tio n s u fferin g fro m o n e o r m o re types o f
oral disease. N o t all such p e o p le p erc e iv e th e y
n eed care; and th u s , so m e d o n ot seek care.
T h e b rea k in th e chain lin k in g n e e d , p erc e ive d
n e e d , and action to h ave th e n eed m e t can re
sult fro m a va rie ty o f factors: g eo g rap h ic dis
tan ce fro m a so u rce o f ca re , financial resources,
level o f e d u c a tio n , social and psychological
characteristics, o r p revio u s e x p e rie n c e in re
ceiving d en tal care services. W h e re th e chain
b e tw e e n n eed and actio n is n o t b ro k e n , e ffe c
tive d e m a n d can b e o b ta in e d .
Because o f breaks in th e c h ain , e ffe c tiv e d e
m and is less than existing n e e d . It is also a p p ar
e n t, h o w e v e r, th a t changes can o ccu r in such
m atters as dispo sable in c o m e , g eo g rap h ic d is
tances, o r p ersonal p erc e p tio n s th a t affe ct th e
w ay in w h ic h an in d ivid u al o r g ro u p o f in d iv id u
als w ill act. T h u s, o v e r tim e , th e level o f e ffe ctiv e
d e m a n d varies, and m easu re m e n t of th e d eg re e
o f va ria b ility m u st be in te g ra te d in to a m a n
p o w e r p la n n in g system . Itre la te s n o to n ly to th e
v o lu m e , b u t also to th e m ix o f services th a t w ill
b e u tilize d .
778 ■ JADA, Vol. 96, May 1978
In D P IS , th e u tiliza tio n m o d e l, w h ic h p ro
vid es estim ates o f e ffe c tiv e d e m a n d , has tw o
c o m p o n e n ts . T h e first is th e rate at w h ic h ser
vices are c o n su m e d — th e p e r capita e ffe c tiv e
d e m a n d fo r services b y a sp ec ified g ro u p o f
p e o p le . If certain characteristics are k n o w n
(age, sex, in c o m e , level o f e d u c a tio n , o r race),
so m e es tim a te o f d en tal b e h a v io r can b e m a d e.
T h e seco n d c o m p o n e n t is p o p u la tio n size,
since total u tiliza tio n o f services is also a fa c to r
o f th e n u m b e r o f p e o p le in a p o p u la tio n w h o fit
vario us s o c io e c o n o m ic characteristics.
T h e e stim atio n process used by th e D P IS can
b e a p p lie d to th e n a tio n , to n atio n al re g io n s , to
in d ivid u al states, o r to substate regions w ith
p o p u la tio n s o f at least 200,000. T h e a b ility to
calcu late re ason ab le estim ates fo r study regions
d im in ish es b e lo w th e p o p u la tio n level o f
200,000. (P o p u latio n g ro up s and s o c io e c o n o m ic
data on th e m are availab le fro m th e B ureau o f
th e C ensus on a c o u n ty -g ro u p basis.)
By in c o rp o ra tin g d en ta l b e h a v io r d ata on th e
n u m b e r an d ty p e o f d e n tis t visits d u rin g a tw o -
w e e k p e rio d fo r a p a rticu lar d en tal service (p ro
v id e d on tapes fro m th e H E W 1971 N a tio n a l
H e a lth In te rv ie w S u rvey), th e DPIS u tilizatio n
m o d el estim ates th e e x p ecte d n u m b e r o f d en tal
visits and th e e q u iv a le n t n u m b e r o f V W S s.
T hese estim ates are calcu lated on a reg io n a l
basis and fo r given gro up s w ith in regions.
As p rev io u s ly n o te d , 21 states c u rre n tly p a rtic
ip ate in th e DPIS th ro u g h th e ir c o n s titu e n t d e n
tal societies. In c lu d in g th e th re e p ilo t states,
q u e stio n n aires fro m 11 o f th ese states have
b ee n processed as o f M a rch 1978. T ables 1 , 2 ,
and 3 p re s e n t som e co m p ariso ns o f d en tal p e r
sonnel u tiliz a tio n , p ro d u c tiv ity , p e r capita e f
fec tiv e d e m a n d , and a p p o in tm e n t sch e d u lin g
p atterns . (Letters w e re assigned at ra n d o m to
id e n tify th e 11 states.)
T a b le 1, ro w 1, show s th a t d en tis ts' es tim ate d
average ch airside tim e in state H (6.65 h ou rs) is
8.13% g re a te r th an th e averag e in state F (6.15
h ou rs). M id d le values o f d en tists' estim ated av
erag e c h air u tiliza tio n are 1.98 chairs (state G)
and 2.10 chairs (state F). R ow 7 shows th a t th e
estim ated average tim e d entists sp en d d a ily
tre a tin g patien ts is 7.92 h ou rs in state K and 9.24
h ou rs in state H . T h e p ro p o rtio n o f d entists in
g ro u p p ractic e is estim ate d to range fro m 15% in
state B to 31% in state I (ro w 6). Estim ates o f th e
average n u m b e r o f years since d en tists' g ra d u a
tio n range b e tw e e n 16.44 years in state B and
21.92 years in state D (ro w 5). T h e e s tim ated
4. Table 1
ESTIMATED AVERAGES OF DENTISTS’DAILY OUTPUT AND AVERAGES OF
VARIABLES AFFECTING PRODUCTIVITY FOR 11 STATES PARTICIPATING IN THE DPIS
STATE
A JL £. D E X G H i J. K_
1) Dentists’average
chairside time
(hours) 6.64 6.21 6.43 6.41 6.53 6.15 6.42 6.65 6.38 6.70 6.49
2) Average number of
chairs used by den
tists (per day) 2.22 1.70 1.80 1.92 2.21 2.10 1.98 2.27 2.27 1.90 2.16
3) Assistants’average
chairside time
(hours)* 5.28 3.93 4.10 3.97 5.58 4.97 4.07 6.45 4.36 3.81 4.51
4) Hygienists’average
chairside time
(hours) 2.10 2.53 2.19 1.61 3.70 2.13 2.10 2.25 1.70 1.71 1.85
5) Average number of
years since dentists
graduated from dental
school 18.41 16.44 16.95 21.92 18.41 17.93 20.15 17.66 17.89 21.18 18.15
6) Estimated proportion
of dentists in group
practice 17% 15% 22% 30% 21% 19% 23% 18% 31% 27% 20%
7) Average total number
of hours per day
dentists spend treat
ing patients 7.99 8.74 8.89 9.09 8.63 8.65 8.78 9.24 8.90 8.05 7.92
8) Average output per day
per dentist (VWS)** 1197.00 979.44 1110.46 1032.02 1218.33 985.65 1101.95 1166.95 1026.94 1045.00 1032.00
9) Average output per
day (Visits)** 20.00 18.63 19.13 18.90 22.73 18.01 20.42 18.97 18.41 18.00 17.00
* Assistants, as it is presented here, include expanded duty auxiliaries (for those having
such provisions in their practice acts) and chairside dental assistants.
** Output VWS and visits is calculated from the sum of the services provided by the hygienist and
the number of services provided by the dentist (exclusive of those services provided to hygienist
patients).
averag e n u m b e r o f ch airsid e hours s p e n t b y
d en tal assistants (in c lu d in g ex p a n d e d d u ty au x
iliaries fo r th ose states having such p ro vision s
in th e ir p ractice acts, and ch airsid e d en tal assis
tants) is fro m 3.81 in state Jto 6.45 in state H (ro w
3); and by hygienists, th e average is fro m 1.61
h ou rs in state D to 3.70 h ou rs in state E ( r o w 4 ).
D iffe re n c e s in e s tim ated averag e p ro d u c tiv ity
b e tw e e n states (sh o w n in T a b le 1, row s 8 an d 9,
and T a b le 2, row s 1 and 3) are m ain ly a ttrib u ta
b le to variatio ns in ch air an d d en tal p e rs o n n e l
u tiliz a tio n , th e n u m b e r o f years since g ra d u a
tio n fro m d en tal scho o l, and th e p ro p o rtio n o f
d en tists in g ro u p p ractice.
A m o n g th e 11 states, state I and state H have
h ig h e r e x p e c te d u tiliza tio n p e r capita (row s 2
and 4 o f T a b le 2 ). C o rre s p o n d in g ly , fo r th ese
tw o states, estim ates o f th e p e rc e n t o f th e ir
p o p u la tio n n o t visiting a d e n tis t (ro w 5, T a b le 2)
are lo w e r. V ariatio n s in ag e, sex, race, e d u c a
tio n , an d in c o m e are th e p rim a ry factors b e h in d
th e d iffe re n c e s in th e e x p e cte d p e r capita u tili
z a tio n rates am o n g th e 11 states.
T ab le 3 p resents s u p p le m e n ta ry p la n n in g in
fo rm a tio n a b o u t d en tis ts' a p p o in tm e n t s c h e d u l
ing fo r n e w p atien ts. T h e m a jo rity o f d entists in
th e 11 states p ro b a b ly w o u ld ac c e p t a n e w pa
tie n t fo r an e m e rg e n c y a p p o in tm e n t (ro w 3).
M o re o v e r, a m a jo r p o rtio n o f dentists in all 11
states are lik ely to acce p t a n e w p a tie n t fo r a
n o n e m e rg e n c y a p p o in tm e n t. T h e values o f
th ese p ro p o rtio n s are sh o w n in r o w l. O f th ose
dentists re sp o n d in g th a t th e y w o u ld accept a
n o n e m e rg e n c y n e w p a tie n t, a m a jo rity said th at
th e y w o u ld s c h e d u le an a p p o in tm e n t w ith in
tw o w e e k s (ro w 2).
T his, th e n , is an o v e rv ie w o f th e p u rp o s e and
ap p ro ach o f th e D P IS . It is c o m p le x and d e
m a n d in g to create and to use. T h e re are 205
h ealth system s agencies th ro u g h o u t th e nation
w ith th e a u th o rity an d re sp o n s ib ility to m a ke
ju d g m en ts on th e n u m b e r o f d entists and o th e r
d e n ta l p e rs o n n e l n e e d e d in th e ir areas. O n
w h a t basis d o th e y m ake a decision? Federal
h ealth m a n p o w e r law s e x a m in e , at least trie n -
n ially, th e h ealth p ro fess io n 's ed u c a tio n a l net-
DENTAL MANPOWER PLANNING ■ 779
5. Table 2
ESTIMATES OF PRODUCTIVITY, PER CAPITA EFFECTIVE DEMAND, AND OF
THE PROPORTION OF A STATE’S POPULATION NOT VISITING A DENTIST
State
_A JL Ç. ü I ü G H I J K
1) Estimated output* per
year per dentist (VWS) 264,435.00 181,930.55 216,342.97 188,510.79 235,645.70 193,163.25 211,526.99 201,945.56 179,079.00 231,369.00 229,310.00
2) Expended utilization
per person per year
(VWS)
3) Estimated output* per
Dentist per year
(visits)
4) Expected utilization
per person per year
(visits)
5) Expected percent of
population not visiting
a dentist
85.94 88.97 80.87 88.72 73.71 81.79 86.97 93.98 93.84 83.11 75.59
4,470.00 3,461.03 3,726.98 3,452.85 4,397.02 3,529.29 3,920.41 3,282.15 3,210.32 4,053.00 3,907.00
1.32 1.37 1.24 1.36 1.13 1.26 1.33 1.44 1.44 1.27 1.16
55.9 54.45% 57.77% 54.8 60.8 57.30% 55.5 52.46% 52.51% 57.15% 60.0
Output (VWS and visits) is calculated from the sum of the services provided by the hygienist
and the number of services provided by the dentist (exclusive of those services provided to
hygienist patients).
Table 3
ESTIMATED PROPORTIONS REGARDING DENTISTS’APPOINTMENT SCHEDULING
State
H I
Percentage of dentists who would
accept a new patient for
a non- emergency
appointment
Estimated percentage of dentists
scheduling appointments
within 14 days (of those
who would accept new
patients for non- emergency
appointments)
Percentage of dentists who would
be likely to accept a new patient
for an emergency appointment
88.1 94.3 88.8 92.8 95.5 95.0 92.7 95.8 96.1 89.2 93.8
75.8 83.5 75.8 76.5 80.8 88.7 77.4 83.5 90.1 78.6 85.2
91.6 95.1 92.1 89.9 91.1 90.5 89.3 93.1 94.4 89.9 92.3
w o rk s and th e N atio n al H e a lth S ervices C o rp s
places fe d e ra l service d entists in d esig n a ted
sh o rtag e areas. O n w h a t in fo rm a tio n are th ese
actions based? T h e A D A 's o w n p o licies call fo r
increased services to th e p o o r, to all c h ild re n ,
and to th e e ld e rly th ro u g h Part B o f M e d ic a re .
T hese c le arly have an im p ac t on m a n p o w e r
q u e s tio n s , b u t to w h a t degree?
A system p ro v id in g th e in fo rm a tio n o n w hich
ju d g m e n ts can b e based is n ev e r g o in g to be
s im p le r than th e q uestion s it is asked. Because
th e re are p la n n in g n eed s o n th e n a tio n a l, re
g io n a l, state, and c o m m u n ity levels, it is n ot
e n o u g h fo r th e A ssociation o n ly to b e actively
en g ag ed in m a n p o w e r p la n n in g effo rts ; c o n
s titu e n t and c o m p o n e n t societies h ave c o n
c o m ita n t resp o n s ib ilitie s, w h ic h place n e w d e
m ands o n b o th th e size and techn ical q u a lific a
tion s o f state an d local d en tal staffs. H e a lth
m a n p o w e r p la n n in g is essential. It is also d if
fic u lt, c o m p le x , tim e -c o n s u m in g , and e x p e n
sive. B ut, th e n , it's n o t a sim p le w o rld a n y m o re .
T h e re p o rt was p re p a re d by D avid R. D o lk a rt, m a n p o w e r
e c o n o m is t, A D A B ureau o f Econom ic R esearch an d Statis
tics.
1. K lein, L.R. A te x tb o o k o n e c o n o m e tric s . E ng elw oo d
C liffs , NJ, P re n tic e -H a ll, 1974, p 3.
2. A study o f rela tiv e v alu e units o f d e n ta l services. A D A
C o u n cil o n D e n ta l H e a lth and B ureau o f E cono m ic Research
a nd Statistics. JADA 7 0:1 2 0 Jan 1968.
3. C u rre n t estim ates fro m th e h e a lth in te rv ie w survey:
U n ite d States, 1976. D H E W p u b l n o . (PHS) 78-1547, series 1 0,
N o . 119. D e p t o f H e a lth , Edu catio n, a n d W e lfa re , 1977, p 28.
780 ■ JADA, Vol. 96, May 1978
