Conundrums in merging public policy into private dentistry: experiences from Australia’s recent past

2015 ◽  
Vol 39 (2) ◽  
pp. 169
Author(s):  
Raymond Lam ◽  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Primary Care ◽  
Service Provision ◽  
Dental Treatment ◽  
Dental Service ◽  
Unintended Consequences ◽  
Government Support ◽  
Oral Disease ◽  
Oral Diseases ◽  
Access To Primary Care ◽  
The Impact

Oral disease continues to be a major problem in Australia impacting quality of life, the economy and broader health system. Although the understanding of caries and periodontal disease has improved along with increased government support, oral diseases continue to be the most prevalent among all health conditions. This is despite unprecedented levels of funding in the Chronic Disease Dental Scheme and the Teen Dental Plan. Access to primary care dentistry in the private sector, where the majority of dental services are provided, remains a critical issue. Under the current system of dentistry, it cannot be assumed that the practice of dentistry represents a prioritised approach to combat disease patterns based on scientific evidence in primary health and prevention. Drawing on data in relation to these two programs, the present study highlights issues impacting dental service provision. This includes issues such as access and affordability to dental care, sustainability of policy and its unintended consequences, private practice pressures and the impact of remuneration on treatment. This paper argues that without structural reform there will continue to be barriers in implementing policies capable of improving oral health. What is known about the topic? The burden of oral diseases remains high and there continue to be problems in accessing and affording dental treatment. What does this paper add? This paper highlights factors impacting dental service provision and offers potential solutions to improve access to primary care dentistry. What are the implications for practitioners? A consideration of these factors may assist policy makers and governments in formulating effective policies.

scholarly journals Correction to: Measuring the impact of the Afordable Care Act Medicaid expansion on access to primary care using an interrupted time series approach

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Elizabeth A. Brown ◽  
Brandi M. White ◽  
Walter J. Jones ◽  
Mulugeta Gebregziabher ◽  
Kit N. Simpson
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Interrupted Time Series ◽  
Medicaid Expansion ◽  
Time Series Approach ◽  
Access To Primary Care ◽  
The Impact

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals Geographical factors in access: investigating the impact of distance on the use of primary care extended hours, an administrative data study.

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Jen Murphy ◽  
William Whittaker ◽  
Mark Elliot ◽  
Rathi Ravindrarajah
Keyword(s):  
Primary Care ◽  
Negative Binomial ◽  
Unmet Need ◽  
Negative Binomial Regression ◽  
City Region ◽  
Hub Location ◽  
Barriers To Access ◽  
Access To Primary Care ◽  
The Right ◽  
The Impact

IntroductionNHS national targets mandate extended opening hours of doctors’ surgeries as a mechanism for increasing access to primary care, based on the assumption that unmet need is caused by a lack of appointments at the right time. Research has shown that other factors impact access and it may not simply be availability that limits an individual’s ability to access healthcare. Aims and Objectives To determine whether distance, familiarity and deprivation impact on the uptake of extended hours GP services that use a hub practice model. MethodsWe linked an appointments dataset to publicly available population datasets. With that linked dataset, we used negative binomial regression to model count data relating to uses of the extended hours service in one care commissioning group in the Greater Manchester city region. The dataset included 32,693 appointments across 4 hubs serving 37 practices. ResultsFamiliarity and distance are important in predicting the number of uses of the extended hours service at a GP practice level. For a theoretical pair of practices collocated at the hub location, the model predicts a use rate of 101.2 for the non hub compared with 283.7 for the hub, a 180% uplift. For a pair of non-hub practices, one located the mean distance from the hub, the other located one mile further away, the model predicts 64.8 uses for the nearer practice, and 46.5 uses for the far practice, a 28% penalty. ConclusionThe results indicate geographical inequity in the extended hours service. There may be many patients with unmet need for whom the extension of hours via a hub model does not address barriers to access. Providers should consider whether or not this type of model actually works to facilitate access. This is particularly of importance in the context of closing health inequality gaps.

scholarly journals STUDI KASUS PATOLOGI GIGI: KARIES PADA RANGKA MANUSIA ST1, SONG TERUS, PACITAN, JAWA TIMUR ( Dental Pathology Case Study: Caries On ST1 Human Remains, Song Terus, Pacitan, East Java)

2018 ◽  
Vol 10 (2) ◽  
pp. 101-115
Author(s):  
Anita Tamu Ina ◽  
Dyah Prastiningtyas ◽  
Harry Widianto ◽  
Florent Détroit ◽  
Ferry Fredy Karwur ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Human Remains ◽  
Oral Disease ◽  
Dietary Habit ◽  
Oral Diseases ◽  
Dental Pathology ◽  
Comparison Results ◽  
Depth Study ◽  
Macroscopic Observation ◽  
Song Terus

Human remains found in Song Terus (Pacitan, East Java), known as ST1, presented an opportunity of in-depth study in reconstructing how human lived during Early Holocene period in the area. This article focuses on palaeopathological aspects by examining lesions of disease observable in bones and dentition of human remains found in archaeological context. The research done for this article focuses more on dental remains, as teeth are known to have durability and longevity as archaeological finds, and could also provide information on age-at-death, types of diet, and oral diseases which may occurred during a person’s life. Dental caries is one of the most common type of oral disease found in archaeological context. Research methods used are macroscopic observation and literature reference comparison.. Results showed there were nine dentition on this individual (from a total of 27 identified dentition) suffered from caries with various degree of severity. Other types of oral disease noted during observation and analysis were periodontal disease. ST1 might have been suffering from severe caries due to lack of oral hygiene, as well as minimum dental treatment towards emerging oral disease. Nevertheless, these diseases did not seem to be directly caused by ST1’s dietary habit during lifetime. ABSTRAK Temuan rangka manusia ST1 di Song Terus (Pacitan, Jawa Timur) memberikan peluang untuk menelusuri lebih jauh pola kehidupan manusia pada periode Holosen Awal di wilayah ini. Artikel ini berfokus pada aspek paleopatologi yang merupakan salah satu kajian ilmu dalam menelusuri jejak kehidupan manusia di masa lalu melalui penyakit pada tulang dan gigi manusia yang ditemukan dalam konteks arkeologi. Materi penelitian dalam artikel ini menitikberatkan pada gigi manusia yang merekam informasi mengenai masa hidup seseorang, termasuk aspek-aspek perkiraan usia saat mati, jenis makanan yang pernah dikonsumsi, dan penyakit yang pernah diderita. Kasus patologi berupa karies menarik untuk diteliti sebab penyakit ini merupakan salah satu kasus yang umum ditemukan pada sisa rangka manusia. Metode penelitian yang digunakan adalah observasi makroskopis dan metode pustaka. Hasil analisis menunjukkan bahwa dari 27 gigi tersisa pada individu ST1, terdapat sembilan gigi yang terdeteksi mengalami karies dan beberapa gigi lain yang menderita penyakit periodontal. Karies pada individu ini tampak disebabkan oleh mikro-organisme yang berkembang di dalam mulut akibat minimalnya perawatan kesehatan gigi dan mulut, serta tidak berhubungan langsung dengan asupan nutrisi yang dikonsumsi oleh individu ini pada masa hidupnya.

scholarly journals A tool to identify potential primary care presentations in the hospital emergency department

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Schütze ◽  
R Rees ◽  
S Asha ◽  
K Eagar
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Public Health Issue ◽  
Accurate Data ◽  
Hospital Emergency ◽  
Targeted Interventions ◽  
International Trends ◽  
Significant Public Health ◽  
Access To Primary Care ◽  
The Impact

Abstract Background Access to primary care has an impact on health outcomes and is a significant public health issue. Limited access to primary care has seen non-urgent presentations to hospital emergency departments continue to rise globally. A lack of a universal workable definition of what a primary care presentation is has impeded national and international estimations of the true burden. Our aim was to develop a standardised code frame to identify potential primary care patients in the emergency department to allow accurate data estimations to be made, and help inform future interventions. Methods An audit of medical records was conducted in two major hospitals in Sydney, Australia. A code frame was developed, tested and applied retrospectively to five years of data. Results Of 601,168 presentations to the emergency department, 171,906 (29%) were deemed to be potential primary care presentations. The code frame had a sensitivity of 99.9% and a specificity of 49.0%. Conclusions This standardised code frame enables accurate retrospective local and national data estimations of the impact of primary care presentations in the emergency department, which was previously not available. The code frame could be used prospectively to evaluate interventions such as diverting patients to primary care settings, and to identify populations for specifically targeted interventions. The conservative nature of the code frame ensures that only those that can safely receive care in a primary care setting are identified as potential primary care. Key messages This robust tool will enable more accurate data estimations of primary care appropriate presentations in the emergency department, which can assist planning and policy efforts. It can be easily adapted to incorporate triage codes in international settings and provides a useful tool for comparing international trends.

scholarly journals Implementasi Metode Forward Chaining, Certainty Factor dan Dempster Shafer pada Sistem Pakar Diagnosis Penyakit Gigi dan Mulut

2021 ◽  
Vol 5 (2) ◽  
pp. 92-102
Author(s):  
Siti Nurajizah ◽  
Ita Yulianti ◽  
Elin Panca Saputra ◽  
Rani Kurnia Dewi
Keyword(s):  
Information System ◽  
Expert System ◽  
Public Awareness ◽  
Oral Disease ◽  
Oral Diseases ◽  
Certainty Factor ◽  
Insufficient Information ◽  
Forward Chaining ◽  
The People ◽  
The Impact

Dental and oral disease is one of the diseases that has been felt by most of the people. Insufficient information and the limited level of public awareness of the prevention of dental and oral diseases make the impact quite dangerous if not handled properly. An appropriate information system is needed in overcoming and providing solutions for handling a disease as early as possible. Expert systems can be used as a means of information on the treatment of dental and oral diseases. The manufacture of the expert system in this study initially used the forward chaining method, which is a method that searches based on information that is made into a set of rules so as to get a conclusion. However, after re-analysis, two other methods, namely certainty factor and dempster shafer, were also applied in this study with the aim of overcoming the shortcomings of the forward chaining method, one of which is uncertainty in producing a conclusion or diagnosis of disease. Determining the type of dental and oral disease can be known by looking at the symptoms experienced by the patient. The use of an expert system for diagnosing dental and oral diseases can be used as an initial solution in helping someone to treat the disease. The existence of this expert system can be used as consideration in making decisions to determine the type of dental and oral disease quickly, precisely and accurately.

scholarly journals Emergency care access to primary care records: an observational study

2020 ◽  
Vol 27 (3) ◽  
pp. e100153
Author(s):  
Thomas Bowden ◽  
David Lyell ◽  
Enrico Coiera
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Hospital Admission ◽  
Emergency Care ◽  
Patient Characteristics ◽  
Care Access ◽  
Process Outcomes ◽  
Primary Care Record ◽  
Access To Primary Care ◽  
The Impact

ObjectiveTo measure lookup rates of externally held primary care records accessed in emergency care and identify patient characteristics, conditions and potential consequences associated with access.MeasuresRates of primary care record access and re-presentation to the emergency department (ED) within 30 days and hospital admission.DesignA retrospective observational study of 77 181 ED presentations over 4 years and 9 months, analysing 8184 index presentations in which patients’ primary care records were accessed from the ED. Data were compared with 17 449 randomly selected index control presentations. Analysis included propensity score matching for age and triage categories.Results6.3% of overall ED presentations triggered a lookup (rising to 8.3% in year 5); 83.1% of patients were only looked up once and 16.9% of patients looked up on multiple occasions. Lookup patients were on average 25 years older (z=−9.180, p<0.001, r=0.43). Patients with more urgent triage classifications had their records accessed more frequently (z=−36.47, p<0.001, r=0.23). Record access was associated with a significant but negligible increase in hospital admission (χ2 (1, n=13 120)=98.385, p<0.001, phi=0.087) and readmission within 30 days (χ2 (1, n=13 120)=86.288, p<0.001, phi=0.081).DiscussionEmergency care clinicians access primary care records more frequently for older patients or those in higher triage categories. Increased levels of inpatient admission and re-presentation within 30 days are likely linked to age and triage categories.ConclusionFurther studies should focus on the impact of record access on clinical and process outcomes and which record elements have the most utility to shape clinical decisions.

Improving access to primary care: the impact of a quality-improvement strategy

2010 ◽  
Vol 19 (3) ◽  
pp. 248-251 ◽  
Author(s):  
K. Kirschner ◽  
J. Braspenning ◽  
I. Maassen ◽  
A. Bonte ◽  
J. Burgers ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
Access To Primary Care ◽  
The Impact

scholarly journals Socioeconomic level and the parents’ perception of the impact of oral diseases on their children’s quality of life

2017 ◽  
Vol 15 (2) ◽  
pp. 171
Author(s):  
Naiana de Melo Belila ◽  
Ronald Jefferson Martins ◽  
Cléa Adas Saliba Garbin ◽  
Wanilda Maria Meire Costa Borghi
Keyword(s):  
Quality Of Life ◽  
Public Schools ◽  
Assessment Tool ◽  
Well Being ◽  
Oral Disease ◽  
Oral Diseases ◽  
Socioeconomic Class ◽  
Northwestern Region ◽  
The Impact

Aim: To analyze how parents of different socioeconomic levels perceive the impact of oral diseases on their children’s quality of life. Methods: All parents or guardians of students aged 11 to 14 years old, regularly enrolled in fundamental schooling at public schools of two towns in the northwestern region of the State of São Paulo, Brazil, were enrolled in the study. The questionnaire of “Socioeconomic Assessment Tool” was used to classify the families with regards to socioeconomic class and the “Parental-Caregiver Perceptions Questionnaire (P-CPQ)” was used to verify the parents’ perception of the impact of oral diseases on their children’s quality of life. Results: 172 (41.8%) individuals answered the survey. Among them, most belonged to the Upper Low Class (61%). 21.5% of the individuals answered that they considered their children’s oral health “regular or bad” and 71.5% answered that their child’s general well-being was not or was little affected by the condition of his/her teeth, lips, jaws or mouth. There was an association between the quality of life sub-scales, especially “oral symptoms”, with all socioeconomic classes. Conclusions: There is a relationship between parents’ socioeconomic class and the perception of the impact of oral disease on their children’s quality of life.

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