|Year : 2021 | Volume
| Issue : 5 | Page : 435-440
Factors associated with preferences for ambience and human resources among adult patients during dental office care: A logistic regression study
Jaime Otero-Injoque1, Luis Ernesto Arriola-Guillén2, Frank Mayta-Tovalino3
1 Department of Master in Senior Management and Health Services, Universidad Científica del Sur, Lima, Peru
2 Division of Orthodontic, School of Dentistry, Universidad Científica del Sur, Lima, Peru
3 Postgraduate Department, Faculty of Health of Sciences, Universidad Científica del Sur, Lima, Peru
|Date of Submission||23-May-2021|
|Date of Decision||20-Jun-2021|
|Date of Acceptance||09-Jul-2021|
|Date of Web Publication||11-Oct-2021|
Dr. Frank Mayta-Tovalino
Postgraduate Department, Faculty of Health of Sciences, Universidad Cientifica del Sur, Av. Paseo de la República 5544, Miraflores 15074, Lima.
Source of Support: None, Conflict of Interest: None
Aim: Focussing on adult patients, this study evaluated the factors associated with preferences for ambience and human resources when receiving care at dental offices in Peru. Materials and Methods: We conducted an observational, retrospective, and analytical analysis of data previously obtained through an anonymous survey among Peruvian patients (n = 618) who visited an American Dental Center in Lima, Peru between 2018 and 2020. The statistical analyses were conducted using the frequencies and percentages of each preference, whereas a χ2 test and logistic regression were used to identify the factors associated with patient preferences (significance determined at P < 0.05). Results: Preferences were expressed at a rate of 80.9%, with the highest frequencies found for appointment time (91.7%), the delegation of certain functions to assistant personnel (89%), and environmental privacy (89%). Further, the logistic regression model showed that only age influenced the day of the week on which respondents preferred to receive care (odds ratio = 0.97, confidence interval: 0.95–0.98, P < 0.001). Conclusion: Respondents reported strong preferences for several elements related to ambience and human resources while receiving care at dental offices, including the professional ratings/genders of service providers and available amenities.
Keywords: Dental Ambience, Dental Office, Human Resource, Preference
|How to cite this article:|
Otero-Injoque J, Arriola-Guillén LE, Mayta-Tovalino F. Factors associated with preferences for ambience and human resources among adult patients during dental office care: A logistic regression study. J Int Oral Health 2021;13:435-40
|How to cite this URL:|
Otero-Injoque J, Arriola-Guillén LE, Mayta-Tovalino F. Factors associated with preferences for ambience and human resources among adult patients during dental office care: A logistic regression study. J Int Oral Health [serial online] 2021 [cited 2021 Dec 8];13:435-40. Available from: https://www.jioh.org/text.asp?2021/13/5/435/327862
| Introduction|| |
Studies have shown evidence of continual advancements in several areas of the dental profession, including the overall number of dentists, participation of women in dental unionization, specialization among dental surgeons, environmental arrangements of dental facilities, the general level of business competitiveness, and the application of business tools. In this regard, some issues are directly related to oral health, including the choice of dentist, satisfaction among dental patients, and acceptance/completion of comprehensive dental treatments. This makes it important to consider whether the preferences of patients are related to increased performance and satisfaction, especially regarding factors that are associated with the dental office.
While previous studies have attempted to understand how patient preferences are influenced via the dental office by taking exploratory approaches in different settings, there is still a lack of definitive evidence showing what preferences are most important and how they are influenced.
Marketing research has shown that business sustainability implies both the ability to identify the power wielded by the customer and the willingness to directly explain products and services, thereby satisfying the special needs of target audiences. Focussing on the health services delivery environment, studies have therefore investigated how patients express their desire for certain options and the extent to which these preferences influence clinical decision-making.
Preferences usually develop through interactions between many associated factors that are related to both the patient and health service. This becomes multidimensionally evident when they are deciding which professional and/or health center to do business with and includes factors such as willingness to pay, satisfaction with received health services, and follow-ups on therapeutic recommendations.
Thus, this study evaluated the factors associated with preferences for ambience and human resources among adult patients when receiving care at dental offices in Peru.
| Materials and Methods|| |
In this analytical, retrospective study, we conducted a secondary analysis of anonymous data (entire population; n=618) obtained during a management survey conducted at the American Dental Center in Lima, Peru between 2018 and 2020. This study evaluated the total population, so it was not necessary to carry out a sampling technique. This manuscript was written following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
For analysis purposes, the survey inclusion criteria stipulated that those respondents must be at least 18 years of age and complete all items (i.e., age, gender, and items related to their preferences). In relation to the exclusion criteria, those patients whose data record was incomplete were separated.
We first gained permission to use the survey data from the dental center, which had created a digital database containing all medical records. In this regard, confidentiality was guaranteed for each respondent. Specific areas of data included gender, age of the oral health professional, size of the dental center, environmental privacy where care was given, degree to which functions were delegated to assistant staff members, and the dates/times/durations of appointments. This questionnaire only performed a content validation with a kappa coefficient of 0.78 because only specific data were collected according to dental care through the data collection sheet.
The study was reviewed and approved by the Institutional Committee for Research Ethics of the UCSUR (Southern Scientific University) with registration no. 40-CIEI-Científica-2020.
Statistical analyses were performed using the IBM SPSS statistical software (version 19.0; IBM, Armonk, NY, USA); frequencies/percentages for each variable and their degrees of association were determined using the χ2 test (significance determined at P < 0.05), whereas a logistic regression [odds ratio (OR)] was conducted to identify any associated factors that influenced the preferences expressed by patients who had received dental care.
| Results|| |
It was found that the male sex was the most predominant with 61.2%, whereas the female sex was only present in 38.8%. In relation to age, most patients were young adults <30 years, composed of 76.4% [Table 1].
|Table 1: Sociodemographic characteristics of the population adult patients during dental office care|
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Regarding the survey section related to patient preferences for human resources in dentistry, 56.4% preferred that their dental care be provided by one dentist and one dental assistant, whereas 14.0% had no preferences; meanwhile, smaller percentages expressed preferences for several dentists and several dental assistants (12.3%), only one dentist (working alone) (12.3%), and one dentist working with several assistants (4.8%) [Table 2].
|Table 2: Preferences of the respondents regarding the human resources of the dental center, according to gender and age|
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When asked about the degree of delegation when providing care, 79.1% of the respondents said they preferred that the dentist performs all treatments, whereas 9.8% said they were comfortable with assistant personnel performing simple procedures. The remaining 11% answered “don’t know/don’t think” [Table 2].
As for the gender of the dentist, 44.5% of the respondents said they preferred to be treated by women, followed by 39.97% who did not indicate any such preferences and 15.5% who preferred to be treated by men. Notably, respondents under 30 years of age statistically and significantly tended to prefer being treated by dentists who were women (P = 0.029) [Table 2].
Regarding the age of the treating dentist, 55.3% said they preferred a dentist between 30 and 50 years of age, whereas 21.3% preferred those under 30 and 2.4% preferred those over 50. In contrast, 20.8% had no preferences about age. We also found that respondents over 30 years of age statistically and significantly tended to prefer dentists between 30 and 50 years of age (P = 0.005) [Table 2].
As for the physical resources and arrangements of dental offices, 40.9% of the respondents preferred medium sizes with two to three chairs, whereas 17.9% preferred small sizes with one armchair and 13.4% preferred large sizes with more than three armchairs. Regarding privacy in the clinical environment, 80.1% of the respondents said they preferred total privacy, whereas 8.9% were satisfied with shared spaces and 11% answered “don’t know/don’t think” [Table 3].
|Table 3: Respondents’ preferences regarding the physical resources of the dental center, according to sex and age|
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Finally, respondents gave their opinions on time management issues in terms of scheduling and appointment duration. In this regard, 38.8% and 38.3% of the respondents preferred to be attended Monday–Friday and Saturday, respectively, while only 8.9% preferred Sunday. On the contrary, 13.9% had no preferences. Here, respondents older than 30 years of age statistically and significantly preferred the Monday–Friday timeframe (P = 0.002) [Table 4].
|Table 4: Respondents’ preferences regarding the scheduling and duration of appointments, by sex and age|
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As shown in [Table 5], the logistic regression revealed that respondent age was associated with preferences for attending dental consultations on particular days of the week [OR = 0.97, confidence interval (CI) = 0.95–0.98; P < 0.001], but neither age nor gender was associated with other patient preferences.
| Discussion|| |
In this study, findings confirmed the results of previous research showing that dental patients had specific preferences regarding the structure of human resources and physical/management resources implemented at dental centers, particularly for issues such as appointment scheduling. At the same time, these preferences are variously expressed based on influences from different factors. As no previous studies have examined the relevance of and relationships between the various factors investigated in this study, our results should contribute to the establishment of new hypotheses aimed at gaining a deeper understanding of the perceptions and preferences dental patients hold toward specific factors related to dentistry.
It is interesting to note the relevance of time management aspects for most patients, especially in terms of the days, specific times, and durations of scheduled appointments. In this regard, there are clear preferences for specific care shifts, which are often adapted based on personal schedules. At the same time, increased patient age is associated with decreased preferences for visiting dental offices on specific weekdays. This creates a management challenge for dental centers, which must organize efficient appointment systems that can adapt to the preferences expressed by patients while reflecting their own work capacities. Specifically, we found a high preference for the Saturday morning shift. In contrast, many patients also preferred various appointment times between Monday and Friday.
Our results also supported the current literature, in that respondents placed high importance on dental services that were provided directly by the dentist in private care settings. This contributed to better dentist–patient relationships while increasing the sense of confidentiality. In similar regard, many respondents also preferred to receive support and indirect care from assistant staff and therefore visited medium or large facilities that offered several chairs. On the contrary, very few respondents stated a preference for receiving care from one dentist who worked alone (i.e., without assistant personnel and only one dental chair).
Compared with other survey categories, most respondents did not have strong preferences about the gender of their dentist. However, some respondents expressed a preference for women, which supports previous studies, in which female dentists were thought to have better communication skills and oral self-care habits. It should be noted that this factor may also influence the level of continuity between the patient and their professional, as patients tend to change more after being cared for by female dentists.
We also found that respondents preferred younger dental professionals, which was previously reported by both Furnham and Swami and Brennan and Spencer, who noted that younger dentists tend to offer higher-level diagnostic and preventive services when compared with older dentists. These findings suggest that care teams should be structured to contain a predominance of middle-aged and female professionals. This also shows that a comprehensive understanding of multiple factors results in a better picture of what patients generally prefer. Above all, it is important to remember that these preferences influence whether patients are willing to receive/pay for certain dental services, revisit the same professionals, and complete comprehensive dental treatments, thus impacting oral health throughout the general population.
| Conclusion|| |
Patients who require dental care tend to have specific preferences about the environmental ambience and human resources offered at dental facilities. Notably, patient age was the only significant factor associated with these preferences.
Future scope/clinical significance
In this study, we were able to gain insights about the different commercial activities and environmental arrangements offered to clients at the same dental center, thus providing a better understanding of what they specifically preferred during their visits. These preferences are often developed based on a variety of factors that modulate their expectations for dental care and determine whether they are satisfied with their treatments. Here, specific factors include the professionalism of the dentist, duration and management of waiting times at the dental center, pain control during dental care and the level of dental fees, and the level of patient participation in the decision-making process. This knowledge provides dentists and dental managers with a better foundation for developing intelligent business practices and efficiently allocating their dental resources, which is especially important in dental markets with an oversupply of professionals.
We want to thank the Faculty of Medicine of the Universidad Cientifica del Sur.
Financial support and sponsorship
None to declare.
Conflicts of interest
The authors have no conflicts of interest.
Study conception (JOI, LEAG), data collection (JOI, LEAG), data collection and analysis (JOI, LEAG), data interpretation (FMT, LEAG), and manuscript writing (FMT, JOI, LEAG).
Ethical policy and institutional review board statement
The research was approved by the Institutional Research Ethics Committee (No. 40-CIEI-Científica-2020).
Declaration of patient consent
Not applicable because it worked with a secondary database.
Data availability statement
All data that support the study results are available from the corresponding author (Dr. Frank Mayta-Tovalino, e-mail: [email protected]) on request.
| References|| |
Panda A, Garg I, Shah M. Children’s preferences concerning ambiance of dental waiting rooms. Eur Arch Paediatr Dent 2015;16:27-33.
Registro Nacional de Instituciones Prestadoras de Servicios de Salud RENIPRESS [Internet]. Superintendencia Nacional de Salud. 2020. Available from https://www.gob.pe/susalud/ [accessed February 22, 2021].
Furnham A, Swami V. Patient preferences for dentists. Psychol Health Med 2009;14:143-9.
Ungureanu MI, Mocean F. What do patients take into account when they choose their dentist? Implications for quality improvement. Patient Prefer Adherence 2015;9:1715-20.
Habib SR, Ramalingam S, Al Beladi A, Al Habib A. Patient’s satisfaction with the dental care provided by dental students. J Ayub Med Coll Abbottabad 2014;26:353-6.
Fukai K, Yoshino K, Ohyama A, Takaesu Y. Dental patient preferences and choice in clinical decision-making. Bull Tokyo Dent Coll 2012;53:59-66.
Asokan A, Kambalimath HV, Patil RU, Maran S, Bharath KP. A survey of the dentist attire and gender preferences in dentally anxious children. J Indian Soc Pedod Prev Dent 2016;34:30-5.
] [Full text]
Hazlewood GS. Measuring patient preferences: An overview of methods with a focus on discrete choice experiments. Rheum Dis Clin North Am 2018;44:337-47.
Williams N, Fleming C, Doubleday A. Patient and provider perspectives on shared decision making: A systematic review of the peer-reviewed literature. J Comp Eff Res 2017;6:683-92.
Wyatt KD, Branda ME, Inselman JW, Ting HH, Hess EP, Montori VM, et al
. Genders of patients and clinicians and their effect on shared decision making: A participant-level meta-analysis. BMC Med Inform Decis Making 2014;14:81.
Zimmerman RS. The dental appointment and patient behavior. Differences in patient and practitioner preferences, patient satisfaction, and adherence. Med Care 1988;26:403-14.
Brennan DS, Spencer AJ. Dentist preferences for patients: Dimensions and associations with provider, practice, and service characteristics. Int J Behav Med 2006;13:69-78.
Huraib SB, Nahas NA, Al-Balbeesi HO, Abu-Aljadayl FM, Vellappally S, Sukumaran A. Patient preferences in selecting a dentist: Survey results from the urban population of Riyadh, Saudi Arabia. J Contemp Dent Pract 2015;16:201-4.
Kfouri MDG, Moysés ST, Gabardo MCL, Nascimento AC, Rosa SVD, Moysés SJ. The feminization of dentistry and the perceptions of public service users about gender issues in oral health. Cien Saude Colet 2019;24:4285-96.
Chung S, Johns N, Zhao B, Romanelli R, Pu J, Palaniappan LP, et al
. Clocks moving at different speeds: Cultural variation in the satisfaction with wait time for outpatient care. Med Care 2016;54:269-76.
Takeuchi K, Noguchi Y, Nakai Y, Ojima T, Yamashita Y. Dentist gender-related differences in patients’ oral health behaviour. J Oral Sci 2020;62:32-5.
Lucarotti PS, Burke FJ. Factors influencing patients’ continuing attendance at a given dentist. Br Dent J 2015;218:E13.
Brennan DS, Chrisopoulos S, Luzzi L, Teusner DN. Dental services provided by dentists in Australia. Aust Dent J 2020;65:90-5.
Barber S, Pavitt S, Khambay B, Bekker H, Meads D. Eliciting preferences in dentistry with multiattribute stated preference methods: A systematic review. JDR Clin Trans Res 2018;3:326-35.
Taibah SM. Dental professionalism and influencing factors: Patients’ perception. Patient Prefer Adherence 2018;12:1649-58.
Inglehart MR, Lee AH, Koltuniak KG, Morton TA, Wheaton JM. Do waiting times in dental offices affect patient satisfaction and evaluations of patient–provider relationships? A quasi-experimental study. J Dent Hyg 2016;90:203-11.
Luo JYN, Liu PP, Wong MCM. Patients’ satisfaction with dental care: A qualitative study to develop a satisfaction instrument. BMC Oral Health 2018;18:15.
Faggion CM Jr, Pachur T, Giannakopoulos NN. Patients’ values in clinical decision-making. J Evid Based Dent Pract 2017;17:177-83.
Lupu IC. The importance of control elements in dental office management. Rev Med Chir Soc Med Nat Iasi 2014;118: 520-3.
Moraes DA, Maluf F, Tauil PL, Portillo JAC. Precarisation of dentistry in private healthcare: Bioethical analysis. Cien Saude Colet 2019;24:705-14.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]