[Future of Regional Health Care in Germany: Where Do Young Dentists Want to Work?] / Zukunft der regionalen Versorgung in Deutschland ­ Wohin wollen junge Zahnärztinnen und Zahnärzte?

STUDY AIM: In the context of a shortfall in medical care, the question arises whether a similar trend in dental care may be anticipated. This study analyses preferred working regions and future town-country distribution of young dentists in Germany. METHODS: This online-survey was conducted in spring 2017. It is the second wave of the longitudinal nationwide study "Y-dent: Professional identity of future and young dentists". Study end points were (1) favoured permanent working region of young dentists, (2) favoured future working city size, and (3) correlation between the region of origin and the favoured working region. RESULTS: 625 (51.2% of contacted) young dentists participated in this study. Dental chambers and associations of health insurance dentists in southern and western Germany were the most favoured future working regions. Regions in eastern Germany as well as smaller regions were chosen less often (<10%). For approximately half of the participants, medium-sized cities were an option, and some young dentists were ready to work in smaller cities. Depending on the federal state, 57-95% of young dentists entertained the idea of working in their region of origin. CONCLUSION: Based on young dentists' statements on their favoured future working region, it can be concluded that there is no risk of a shortfall in dental care comparable to the shortfall in medical care. A proportion of young dentists is willing to work in thinly populated or rural areas.

Professional identity, career choices, and working conditions of future and young dentists in Germany - study design and methods of a nationwide comprehensive survey.

BACKGROUND: Little is known regarding young and future dentists' career choices, professional identity, and working conditions in Germany. While the dental healthcare environment and demands in treatment are changing, it remains unclear what job perceptions young dentists have developed at the beginning of their work life and if and how these perceptions change during the subsequent years. The aim of this study was to survey future and young dentists regarding their professional identity, planned career paths, and working conditions and strains to understand career decisions and choices and enable policy makers to include future dentists' views and expectations in their decisions. METHODS/DESIGN: This study is a longitudinal nationwide survey over a time span of 4 years of dental students and young dentists in Germany and is comprised of three waves. The first wave focuses on dental students in their final year before the state examination and is composed of a qualitative pre-study in the form of focus groups and a quantitative main survey in the form of a questionnaire. The end points were established to analyse (1) the professional identity of the young future dentists; (2) their career paths, preparation for a career, and basic career conditions; and (3) perceived conditions and strains. The aim of the overall survey was to depict the development of these three aspects during the first years of work life. All of the questions were evaluated with a descriptive univariate analysis. The analysed subgroups were grouped according to gender, target working condition (employed/self-employed), and primary socialisation (parents dentists/parents not dentists). DISCUSSION: To our knowledge, this is the only study which focuses on career choices, professional identity, and working conditions of future and young dentists in Germany. The longitudinal observation provides information that is essential for professional and purposive dental health care planning, and to meet the oral health demands and needs of the German population appropriately over the long term. TRIAL REGISTRATION: German Health Services Research Data Bank VfD_Y-Dent_14_003759 .

Oral health status and coverage of oral health care: A five-country comparison.

Oral health has received increased attention in health services research and policy. This study aims to assess oral health outcomes and public coverage of oral health services in Belgium, Denmark, Germany, the Netherlands, and Spain. Various indicators were used to compare oral health outcomes concerning the most common disorders by age group. Coverage of oral health services was analyzed according to the dimensions of the WHO Universal Coverage Cube. The results showed major differences in the coverage of services for the adult population: coverage was most comprehensive in Germany, followed by Belgium and Denmark. In Spain and the Netherlands, public coverage was limited. Except in Spain, coverage of oral health services for children was high, although with some differences between countries. Regarding oral health outcomes measured by the T-Health index, no country showed outstanding results across all age groups. While Denmark, the Netherlands, and Spain performed above average among 5- to 7-year-olds, Denmark and Germany performed above average among 12- to 14-year-olds, the Netherlands, Spain, and Belgium among 35- to 44-year-olds, and Belgium and the Netherlands among 65- to 74-year-olds. The selection of countries of this study was limited due to the availability and quality of oral health data demonstrating the urgent need for the European member states to establish corresponding databases.

Using morbidity and income data to forecast the variation of growth and employment in the oral healthcare sector.

The perception of the health sector from an economic policy point of view is changing. In the past, health expenditure was mostly seen as a "cost" item, probably because many medical treatments are covered by public health insurance. However, policymakers are increasingly realizing that a growing health sector may be quite beneficial for an economy. It creates employment opportunities and it is relatively resistant to the fluctuations of the business cycle. Input-output analysis could be a useful tool to study the structural change resulting from the growth of the health sector. This paper quantifies for the first time the economic significance of the oral healthcare sector as a component of the German healthcare sector as a whole. The current data for the healthcare sector comes from Health Satellite Accounts, which while comprehensive do fail to answer important questions due to not incorporating certain sectors such as the oral healthcare sector. Therefore on the basis of the Health Satellite Account a specific Satellite Account for the oral healthcare sector is created by using billing data as well as epidemiological data, provided by several dental associations and the Institute of German Dentists. Based on this added information, gross value added data and the number of employees in the oral healthcare sector are computed. Gross value added in 2010 amounted to €13.4 billion, with around €4 billion being attributable to the secondary oral healthcare market; the market for solely out-of-pocket payments. In a second step the paper develops a model to forecast oral healthcare sector growth based on various explanatory variables such as demographic change, take-up behaviour, medical-technical progress, oral morbidity, aggregated supply (collective dental treatment times) as well as income levels and distribution, where the latter two are considered to be of particular importance. According to this model, by 2030 gross value added in the oral healthcare sector will amount to €15.9 million, which corresponds to a 19.2 % increase. The secondary oral healthcare market will be the key to this increase since the model predicts a disproportionately high growth of 60.3 % bringing the total to €6.3 million gross value added in 2030.