Determinants of costs of orthodontic treatment in the Finnish public health service

Factors affecting the costs of children's free orthodontic treatment were studied from patient records of a random sample of 193 successfully treated orthodontic patients, aged 7-14 years at the start of the treatment. They were treated by orthodontic specialists in the health centers of the cities of Joensuu, Oulu, and Vaasa. The statistical analysis was done using advanced regression analysis, two-tailed t-test and chi-square test. The results indicated that the number of appliances used, the patients' ages at the start of treatment, the number of missed appointments, differences between health centers, and the change in PAR (Peer Assessment Rating) Index scores accounted for 78.7 % of the variations in treatment costs. The number of appliances used was the most important factor in the regression (R2=0.657). The costs of treatment were lowest in one-stage treatments started in the permanent dentition, and were highest in two-stage treatments started in the mixed dentition. Significant differences were found in treatment patterns and costs between the three health centers, reflecting low concern for cost-efficiency aspects.