Satisfaction, Utilisation and Willingness to Pay for Primary Care Dental Services

Abstract

It is a common objective to strive for better health. Keeping one's teeth healthy and practising appropriate oral hygiene are essential but frequently overlooked aspects. Poor dental health can have a detrimental effect on speech, diet, and general well-being and has been related to a range of serious health conditions. Nevertheless, there are substantial obstacles to receiving prompt, reasonably priced dental care. User preferences can offer insights into the publics’ perceptions of dental services' how they are valued and used. Potential disparities in oral health and the effectiveness of the healthcare system can also be found by analysing preferences differently among social groups. This emphasises how crucial oral health equity is to enable everyone to reach the highest standards regardless of social or economic background. This thesis aims to examine satisfaction, utilisation, and Willingness to Pay for dental care, to identify the underlying factors that lead to differences across these among various groups of individuals, and to assess how the context in which care is delivered affects them. The thesis consists of a number of studies, that use primary and secondary data from Saudi Arabia and the United Kingdom. It seeks to understand the perception of dental services, how these vary and what lessons might be learnt from this with respect to policy. The thesis is laid out in five chapters. In Chapter 1, the background to the study is provided and motivation for the subsequent empirical chapters set out. In Chapter 2 an empirical study that examine satisfaction with dental services are presented using the Donabedian framework to relate care quality to satisfaction. In this study, data from the British Social Attitudes Survey (BSAS) is used to examine the differences in satisfaction across different demographic groups and to track the development of this satisfaction over time. The chapter demonstrates using data from the UK, how satisfaction with dental services can vary within a publicly funded system throughout an economic cycle as the opportunities for private practice change and with it, access to dental care among publicly funded patients. Importantly the chapter underscores the challenges in analysing and interpreting the results of satisfaction survey data. In Chapter 3, the focus shifts to the utilisation of dental care, using the Andersen model as a conceptual framework. The chapter has been divided into two main sections. The first section emphasises the significance of accurately describing the concept of 'need' when examining variations in dental care use. Using data from the Scottish Health Survey, it highlights distinctions between those who use services for prevention and those who use services for treatment attention terms of their socio-demographics. The following section examines differences between regions in use of services that might be concealed by national statistics. The second study demonstrates the existence in Saudi Arabia of distinct patterns across regions in use of care related to socio-demographic characteristics of users. In Chapter 4, satisfaction with, utilisation of, and willingness to pay for dental care services in Saudi Arabia are examined using primary data analysis that collected face to face and online. the first study examines satisfaction with dental care in Saudi Arabia by conducting a comparative analysis of in-person and online surveys. This study highlights the possible influence of survey administration techniques on research findings. This study shows how overall satisfaction varies as satisfaction with specific aspects of service but not others vary, demonstrating that amenities and communication are critical drivers of overall satisfaction. In the second empirical study the utilisation of services as reported in face-to-face surveys and online surveys in Saudi Arabia are examined on the potential for sample selection is explored using data gathered during the COVID pandemic and its aftermath. In the third study, the utility theory used to examine the willingness of individuals in Saudi Arabia to pay for dental check-ups using online survey responses in Saudi Arabia. This study presents as a proof of principle a study of WTP in Saudi Arabia and amines differences in willingness to pay among various demographic groups. The validity of the study's estimated willingness-to-pay is validated internally and externally. It also examines the more general implications of these findings for fairness and healthcare policy, providing a thorough assessment of the financial elements of dental service accessibility and cost in Saudi Arabia. In the final chapter the lessons from across the various empirical studies are discussed, strengths and limitations of the work examined and areas for further research identified.