The quality of public and private dentistry in Malta: patients' perceptions and experiences

Abstract

Systematic evidence about how the public perceives and experiences the quality of general dental care is very limited in Malta. The main reason for carrying out this study was to analyse the perceptions, experiences and satisfaction with the quality of dental services in Malta (both public and private) by the general public. The objectives of the study were: 1. To identify the criteria which the public perceives as being the most important when evaluating dental care services. 2. To identify how certain socio-demographic characteristics influence the patients' pattern of dental attendance and their attitudes towards dental care. 3. To determine patients' perceptions about differences between public and private dental services. The study was an exploratory descriptive research type and employed a questionnaire as the research tool. This was based on the questionnaire of Professor Calnan after obtaining permission from him. It was carried out in public and private dental clinics in Malta and a total of 240 questionnaires were completed. The questionnaire included questions on pattern of use of general dental care as well as mode of dental care (i.e. public or private or both), attitudes to dentistry in general and satisfaction with different aspects of dental care. Satisfaction was probed by comparing perceived and/or experienced differences between public and private dental care on a number of issues ranging from availability and physical environment (surgery and equipment), to technical skills and interpersonal care. Perceptions on the mode of dental care and views about dentists' skills were assessed using a five-point Likert scale. Evaluation of quality of general dental care from the public's point of view hinges on perceived technical skills, dentist's manner and the ability to decrease pain. The evidence also shows greater satisfaction with most aspects of private dental care than with public dental care. One of the attractions of the private sector is in its perceived accessibility and its more pleasant surgery environment. Roughly, pain management, infection control management as well as the accuracy with which treatment is carried out are perceived as being of the same quality in both public and private settings. Also, cost is not seen as a barrier to dental care. Socio-demographic characteristics influence patients' attitudes towards dental care. Regarding the gender issue, one can note that females arc more aware of the importance of attending to the dentist on regular basis as opposed to males who present to the dentist when needed especially if in pain. Also it seems that as patients get older, they no longer visit the dentist on a regular basis. Those individuals who had no schooling at all and half of those having a primary level of education, visited the dentist only when in pain. The results also demonstrate that those respondents who had a secondary level of education are the most regular attenders. When it comes to choosing the mode of dental treatment - public or private, age and gender do not seem to impart any significant difference. This study identifies that patients in addition to health care professionals are key players in defining and measuring quality and their voice provides important feedback to the process