A content analysis of dental capitation plan grievances

As the health care system becomes more impersonal, competitive, and cost conscious, there is a potential for increased dissatisfaction with health care providers. This paper describes the use of content analysis to examine aspects of patient dissatisfaction with delivery of health services in a capitated dental plan. All written complaints from three regions of California from June 1984 to June 1986 were collected, and a content analysis was performed on these letters. The rates of grievances differ substantially across regions; however, three regions were similar in their grievance patterns. Access to care was the single largest category of concern, and these grievances were registered because patients had to wait for an appointment (35 percent) or had to wait in the office (32 percent) to receive care. Provider technical competence was the second largest category. Significant variables from a logistic regression that predicts complaint status of an eligible member are (1) years covered, (2) age, and (3) income. The grievance rate and grievance categories described in this study can help define new strategies and policies in the overall mission of a dental capitation organization.