type of care, cost and availability of dental facilities. Certain questions were asked which developed the demographic characteristics of the individual respondent and his dependents. Finally, the respondent was given an opportunity for expressing personal remarks concerning dependent dental care. 1 and The sampling procedure initially divided the continental United States into nine geographic areas following the classification utilized in surveys conducted by the Bureau of the Census American Dental Association." 2 Within these regional areas, major military installations which had not been previously designated as in a "remote area" under criteria established by the Uniformed Services Health Benefits Program directive of February 1967 (Army Regulation 40-121) for purposes of dependent dental care were included for participation in the survey. A further condition for the selection of installations was the stratification of installations into locations which were representative of rural areas, small civilian communities, or large urban areas. Fifty such installations (see Appendix A) were selected for a nationally representative mix regardless of service affilation. 1 U.S. Bureau of the Census - Statistical Abstract of the 2 United States: 1967, (88th edition) Washington, D.C., 1957. American Dental Association, Eureau of Economic Research and Statistics. Survey of Reeds for Dental Care, 1965. Chicago, 1965. It is conceiveable that every military and civilian employec at these fifty installations could have been surveyed. How ever, such an ennumeration would have been inefficient in terms of time and money in studying a defined population. It is well recognized that a relatively small number of carefully selected individuals may represent the total population within useful limits of error when selected in a statistically valid manner. However, in order to possess reliability of results from such a sample, it is essential that the sampling procedures for selection of respondents be so controlled as to guarantee random selection. That is to say, the actual persons who constitute the sample are chosen in an unbiased manner and in such a way that each person in the total population has an equal chance to be selected. It was initially determined that the number of participants in the survey should not exceed 6,000 military and 6,000 civilians in order to satisfy certain technical considerations and to fulfill the requirements of expediency. The military sample was stratified by the size and pay grade of the installation military population. The civilian sample, however, was stratified only by size of civilian population at each installation, since no information was immediately available on grade distri The actual selection of respondents was done at each installa tion based on criteria established for stratification and under conditions which assured randomness. In all, 5,024 military and 4,656 civilian personnel participated in the survey. Participants' responses to the objective-type questionnaire items were edited and run through a computer to prepare programmed tabulations for analysis. Additionally, personal remarks submitted by the respondents were reviewed and categorized. ANALYSIS An important consideration throughout the analysis of the survey data was the underlying fact that civilian dental care is an individual elective action. An individual must recognize the need for dependent dental care, be motivated to fulfill the need, and resolve, within the constraints of other obligations and circumstances to act at a particular time. Under pressed financial conditions, children's dental care may take precedence over a wife's dental needs and minor or partial treatment may be undertaken in lieu of obtaining more extensive care. In the case of a serviceman, he may procrastinate or justify putting off required dependent dental care until assigned to a location where the benefits of free dental care are available for his dependents. Moreover, the influence of socio-economic, demographic and more than non-whites, and that patterns of dental care vary with age. In order to facilitate the analysis of responses, military Groups according to base pay as shown in Appendix B. corresponded directly to those used in studies of dental American Dental Association. Additionally, consideration was given to the family unit, the regional area location and the length of residence at that. location at the time of the 4 U.S. Public Health Service, National Center for Health Statistics. Volume of Dental Visits, United States: July 1963 - June 1964, Series 10 Number 23. Washington, D.C., 1964. DISCUSSION OF FINDINGS 1. UTILIZATION OF CARE The initial analysis of survey results was to establish the need for dental care and the degree to which that need was satisfied. This necessitated an analysis of such topics as the specific types of dental care required and received, and the problems associated with the acquisition of dental ser vices. An overall view of the acquisition of dental care for dependents provided by Table 1 shows that 17% of the military and 19% of the civilian sample asserted that care was not required last year for their dependents. Another 54% of the military and 67% of the civilian sample were able to obtain required care for their dependents. Although approximately the same proportion of each subpopulation indicated an absence of need for dental care, the margin of difference widens significantly when one considers actual acquisition of care required; twice as many military dependents as civilian dependents did not get the care they needed last year. This is reported as 29% and 14% for military and civilian samples respectively. This table further shows that in every instance, when broken out by Grade Group, military respondents claimed a substantially higher proportion of dependent dental care required but not obtained than their civilian counterparts. This |