Trial of combination of capitation and case payment scheme for root canal treatment in dental clinics in primary care facilities

Abstract

The case payment system is a scheme where health service providers are paid according to a predetermined fee with a fixed amount per disease, with a precise diagnosis and treatment plan. One of the examples is root canal treatment. Root canal treatment is a dental treatment to treat carious teeth which involve the dental pulp tissue and to keep the teeth in the oral cavity for a long time. This study looks at the impact of testing the application of a combined capitation and case payment system for root canal treatment in primary care facilities. This research was conducted in a branch office of Social Security Agency of Health (BPJS Kesehatan) in Pekanbaru, Riau Province, and involved 15 primary care facilities. This study used a cross-sectional mix method, by observing data on the implementation of root canal treatment, focus group discussions, and questionnaires. The root canal treatment was performed on 56 patients, with 58 teeth diagnosed with acute irreversible pulpitis and pulp necrosis. The most commonly treated teeth in the root canal treatment were premolars. The results showed that the root canal treatment satisfaction level according to the patient and doctor respondents were at strongly satisfied level. No respondents dissatisfied with the root canal treatment. The results of the FGD with the participating dentists showed that there was still dissatisfaction with the amount of full-payment for case payment, which was set at IDR 700,000. The trial of the combination of capitation and case payment scheme for root canal treatment was acceptable to dentists who worked in primary care facilities and was at a reasonable satisfaction level for dentists at dental clinics. Participants who received root canal treatment were also satisfied with the treatment.