DT News - Nordic - Finnish study shows patients could benefit from more support in using dental vouchers

Anisha Hall Hoppe, Dental Tribune International

Fri. 21 April 2023

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HELSINKI, Finland: Dental care accessibility is an issue facing many countries with some such as Finland addressing the unserved population by creating a unique voucher system to ensure all patients in the public healthcare system receive care, even by private providers. Through a questionnaire, a team in Finland has investigated the perspective of adult patients on using a recently introduced type of dental service voucher in an effort to improve accessibility to the system. The responses to the survey indicated that though the new system is an improvement, patients still require more support to use the subsidised vouchers effectively.

The voucher system in Finland was created to mitigate treatment gaps created by an overfull public dental service by subsidising the treatment costs of private providers. Five types of vouchers have been created since the system’s inception in 2011, and the vouchers can be used fully or partially to cover various aspects of dental treatment planning and implementation.

Called KOHO, the new voucher system introduced in 2021 improved upon previous voucher schemes, which resulted in partially used vouchers that increased demand but sometimes resulted in incomplete dental treatment or treatment split between the private and public system. KOHO provides subsidies for non-urgent comprehensive treatment instead of specified treatment types. It also ensures that a private dentist handles the treatment from beginning to end, preventing care being broken up between systems and providers.

The researchers evaluated various aspects of patient experiences of using the new KOHO scheme, including ease of use, whether patients felt that had they received adequate assistance and information, experience with using the electronic service voucher system and whether patients would just prefer to use the public dental service instead of the voucher system. They also included a question on perceived oral health.

While 38.9% of the voucher recipients surveyed had used a voucher before, 31.0% said that that it would have been preferable to use the public dental service instead of using a voucher. More patients (7% more) with good perceived oral health used the voucher system than those with poor perceived oral health. Being able to receive treatment without a significant wait was the primary reason for using the vouchers according to the study, followed by being given no other alternatives for receiving treatment.

The results suggest that more can be done to identify patients who need support to effectively use a dental service voucher, particularly because it is a multistep process. Some patients reported that they felt that they were not treated the same as other patients when they presented their vouchers at a private clinic. Patients also indicated that they had not been given a choice of whether to receive public care or voucher-subsidised care.

While only 24.5% of the participants in this study were elderly, it also built upon previous research which showed that for elderly patients specifically vouchers were more likely to be used for acute rather than preventive services. Past research also found that social and institutional support as well as health status were associated with effective use of vouchers by older patients.

The study, titled “Dental service voucher for adults: Patient experiences in Finland”, was published online on 22 March 2023 in Acta Odontologica Scandinavica, ahead of inclusion in an issue.