Is mix of care influenced by the provider environment? A comparison of four care pathways in oral health

2015 ◽  
Vol 39 (1) ◽  
pp. 51 ◽  
Author(s):  
Yevgeni Dudko ◽  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Dental Care ◽  
Care Delivery ◽  
Clinical Pathways ◽  
Dental Service ◽  
Dental Services ◽  
Government Sector ◽  
Dental Procedures ◽  
International Data ◽  
The Government ◽  
Public Clinics

Objective In Australia, access to dental care has been available through several different pathways: (1) private practice; (2) public clinics; (3) Aboriginal Medical Services (AMS)-based clinics; and (4) until recently, the Chronic Disease Dental Scheme (CDDS). The aim of the present study was to compare the types of dental services most commonly delivered in the various clinical pathways based on the hypothesis that disease-driven care should lead to similar mixes of dental care provided. Methods Data from a series of previously published sources was used to identify and compare the most commonly performed dental procedures in the different pathways. A comparison was also made with the available international data (US). Results There was a marked difference between service mixes provided through the four pathways. Patients obtaining dental care through AMS-based and public pathways had more extractions and less restorative and preventive care compared with private and CDDS pathways. Compared with the international data, dental service mixes in Australia were found to be not as evenly distributed. Value of care provided through private and CDDS pathways were two- to threefold higher than that of AMS-based and public pathways. Conclusion The data indicate that the original hypothesis that the disease-driven care should lead to similar mixes of provided dental care, is not supported. What is known about the topic? The pricing of dental care is a topic that gets substantial discussion in the private sector. However, its effect in the government sector is very limited in its consideration. This research is a bold first step in Australia to look at the influence of different modes of care delivery on the mix of care provided. What does this paper add? This research is a unique first effort to examine the influence of different modes of care delivery on the type of care provided. It clearly highlights that the pathway for care in the government sector do have very different care outcomes. What are the implications for practitioners? The implications are clear; practitioners need to be aware that care is provided in the context of the pathway in which the care is offered and this will influence the type of care provided. Care is not a single outcome and multiple factors influence the outcome for patients.

scholarly journals Dental Care Services for Older Adults in Hong Kong—A Shared Funding, Administration, and Provision Mode

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 390
Author(s):  
Stella Xinchen Yang ◽  
Katherine Chiu Man Leung ◽  
Chloe Meng Jiang ◽  
Edward Chin Man Lo
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Dental Care ◽  
Care Service ◽  
Indirect Evidence ◽  
Dental Service ◽  
Dental Services ◽  
Financial Barriers ◽  
Care Services ◽  
The Government

Hong Kong has a large and growing population of older adults but their oral health conditions and utilization of dental services are far from optimal. To reduce the financial barriers and to improve the accessibility of dental care services to the older adults, a number of programmes adopting an innovative shared funding, administration, and provision mode have recently been implemented. In this review, an online search on the Hong Kong government websites and the electronic medical literature databases was conducted using keywords such as “dental care,” “dental service,” and “Hong Kong.” Dental care services for older adults in Hong Kong were identified. These programmes include government-funded outreach dental care service provided by non-governmental organizations (NGOs), provision of dentures and related treatments by private and NGO dentists supported by the Community Care Fund, and government healthcare vouchers for private healthcare, including dental, services. This paper presents the details of the operation of these programmes and the initial findings. There is indirect evidence that these public-funded dental care service programmes have gained acceptance and support from the government, the service recipients, and the providers. The experience gained is of great value for the development of appropriate dental care services for the older adults in Hong Kong and worldwide.

scholarly journals A Cross-Sectional Analysis of Oral Health Spending Over the Lifespan in Commercial and Medicaid Insured Populations

2021 ◽  
Author(s):  
Eric Tranby ◽  
Julie Frantsve-Hawley ◽  
Myechia Minter-Jordan ◽  
James Thommes ◽  
Matt Jacob ◽  
...  
Keyword(s):  
Oral Health ◽  
Oral Cancer ◽  
Dental Care ◽  
Care Delivery ◽  
Health Spending ◽  
Dental Service ◽  
Fee For Service ◽  
Cross Sectional ◽  
Medical Spending ◽  
Ibm Watson

Background: Life course theory creates a better framework to understand how oral health needs and challenges align with specific phases of the lifespan, care models, social programs, and changes in policy. Methods): Data are from the 2018 IBM Watson Multi-State Medicaid Marketscan Database (31 million claims) and the 2018 IBM Watson Dental Commercial and Medicare Supplemental Claims Database (45 million claims). Analysis compares per enrollee spending fee-for-service dental claims and medical spending on dental care from ages 0 to 89. Results: Dental utilization and spending are lower during the first 4 years of life and in young adulthood than in other periods of life. Stark differences in the timing, impact, and severity of caries, periodontal disease, and oral cancer are seen between those enrolled in Medicaid and commercial dental plans. Early childhood caries and oral cancer occur more frequently and at younger ages in Medicaid populations. Conclusions: This unique lifespan analysis of the U.S. multi-payer dental care system demonstrates the complexities of the current dental service environment and a lack of equitable access to oral healthcare. Practical Implications: Health policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the lifespan.

Private Dentistry after COVID-19 – A Clinician’s Personal Experience

2020 ◽  
Author(s):  
Reginald O’Neill
Keyword(s):  
Dental Care ◽  
Private Practice ◽  
Personal Experience ◽  
Dental Practice ◽  
Health Practice ◽  
Dental Services ◽  
Face To Face ◽  
The United Kingdom ◽  
The Government ◽  
The Uk

Face to face dental care in the UK was largely suspended from March until June and beyond is very limited still in many cases. Both NHS and Private dental services in the four nations of the United Kingdom aligned with the government in lockdown and dental emergencies could be accessed face to face in specific urgent centres only (UDC’s). Return to dental practice has been challenging for the profession with a lack of clarity from regulators and a gulf between financial support of private practice (almost none) and National Health practice (at 100% of their contact value pre-COVID). Dramatic changes to the provision of dental care are likely to persist and the COVID crisis may precipitate significant change to both private and NHS dental services.

scholarly journals Mobile Dental Delivery System: An Effective Protocol for Hygiene and Disinfection

2020 ◽  
Vol 17 (5) ◽  
pp. 1603 ◽  
Author(s):  
Damien Offner ◽  
Gabriel Fernandez De Grado ◽  
Marion Strub ◽  
Laure Belotti ◽  
Stéphanie Deboscker ◽  
...  
Keyword(s):  
Dental Care ◽  
Care Delivery ◽  
Microbiological Quality ◽  
Plate Count ◽  
Heterotrophic Plate Count ◽  
Dental Procedures ◽  
Dental Care Delivery ◽  
Dental Unit Waterlines ◽  
Over Time

Mobile dental delivery systems (MDDSs) are receiving growing interest for reaching isolated patients, as well as in dental care for fragile and hospitalized patients, with the advantage of being able to be used from room to room or during general anesthesia (GA) in an operating room. Therefore, ensuring the care safety is crucial. The aim of this study was to elaborate and assess an MDDS maintenance protocol, containing the management of dental unit waterlines and adapted to specific conditions such as dental care under GA. A step-by-step protocol was established and implemented for an MDDS used during dental care under GA in children. Samples of the output water were collected at J0, J+1, 3, 6, 12, and 24 months, and cultured to observe the microbiological quality of the water. All the results (heterotrophic plate count at 22 °C, at 37 °C, and specific pathogenic germs sought) showed an absence of contamination. The protocol presented was effective over time and allowed ensuring the safety of care to be ensured when using MDDS, even during dental procedures under GA. As a result, it could be implemented by any dental care delivery structure wanting to reinforce the safety of its practice.

scholarly journals Barriers of utilisation of dental services among children and adolescent: A systematic review

2018 ◽  
Vol 30 (3) ◽  
pp. 150
Author(s):  
Avlien Farlina ◽  
Diah Ayu Maharani
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Dental Care ◽  
Dental Service ◽  
Oral Diseases ◽  
Dental Services ◽  
Children And Adolescent ◽  
Care Utilisation ◽  
Economic Barriers ◽  
Low Income Families

Introduction: Underutilisation of dental services among children and adolescent is a worldwide problem that increases caries prevalence. Younger children are less likely to receive dental care and, thus, experience oral diseases more often. This systematic review was aimed to explore the barriers of utilisation of dental services among children and adolescent. Methods: The literature search was conducted in the electronic database of Pubmed©/Medline©. The literature exclusion criteria were adults and qualitative study. Keywords were verified in MeSH. Boolean “AND” and “NOT” was used to specify the search. Twenty-four literature were filtered from Pubmed©, and twenty-three literature fit the inclusion criteria. Result: The result revealed that low-income families, minority ethnic, and disability condition have lower dental care utilisation. Conclusion: The identified potential determinants of oral health and dental care utilisation among children and adolescent are economic barriers, uninsurance, and availability of dental service providers.Keywords: Dental care, dental services, utilisation, barrier, children, adolescent.

scholarly journals A case series analysing patients with dental anxiety: a patient-centred model based on psychological profiling

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1843
Author(s):  
Riccardo Tizzoni ◽  
Laura Veneroni ◽  
Alfonso D'Aloia ◽  
Marta Tizzoni ◽  
Carlo Alfredo Clerici
Keyword(s):  
Dental Care ◽  
Care Delivery ◽  
Dental Anxiety ◽  
Case Series ◽  
Subjective Experiences ◽  
Patient Case ◽  
Care Experience ◽  
Dental Procedures ◽  
Wide Range ◽  
Behavioural Condition

Anxiety and distress can jeopardize dental care experience of patients and may affect the clinical result. Although a wide range of sedation and analgesia techniques are currently available to relieve distress and pain during dental procedures, operative models to choose the most effective sedation-analgesic strategies are lacking. This case series proposes a patient-centred model to optimize patients’ cooperation during dental care delivery. We describe how to achieve correct anaesthesia by using the least sedative procedure, accounting for the dental procedure needed and patient’s psychological profile. Five patients were considered as paradigmatic to show the balance between patients’ subjective experiences and the clinical procedures: a patient with low stress, good compliance (case 1); moderate stress and reduction in compliance (case 2); anxious patient (case 3); patient with acute anxiety and emotional distress (case 4); anguished patient (case 5). A multimodal treatment of emotional and behavioural condition and a patient-centred model approach contributed to achieve the best patient satisfaction in the five cases detailed here.

scholarly journals Dental Service Utilization of a Rural Population in Nigeria

2019 ◽  
Vol 4 (2) ◽  
pp. 62-65
Author(s):  
O.O Osadolor ◽  
◽  
E.A Akaji ◽  
U Otakhoigbogie ◽  
H.C Amuta ◽  
...  
Keyword(s):  
Service Utilization ◽  
Dental Care ◽  
Rural Population ◽  
Household Income ◽  
Dental Health ◽  
Health Centre ◽  
Dental Service ◽  
Dental Clinic ◽  
Dental Services ◽  
Socio Demographic Factors

Background: Dental health is often neglected by a vast majority of the population and has contributed to the global burden of oral diseases. Prevention of disease, disability and suffering should be a primary goal of any society that hopes to provide a decent quality of life for its people. Dental care/service utilization is an indispensable facilitator of oral health, as dental caries and gingivitis are preventable with regular access to preventive dental services. Several reasons have been attributed to use and non-use of dental services and include socio-demographic factors such as age, sex, educational attainment, and household income. Objective: To determine dental service utilization of a rural population in South-east Nigeria. Methodology: A cross sectional study of 268 participants was carried out at Ozalla Model Primary Health Centre, Ozalla Health Centre and Umueze Awkunanaw Health Centre located in Ozalla community and Umueze Awkunanaw community respectively. Ethical clearance for this study was sought and obtained. Permission was sought from the head of each health centre, while individual verbal consent was obtained from the respondents before giving out the pretested questionnaire which was interviewer-administered. Data was analysed using Statistical Package for Social Sciences (SPSS) Version 20. Results: 126(47 %) males and 142(53%) females were seen. The age of the participants ranged from 18 - 86 years with a mean age of 32.4 ± 13.3 years. 131(48.9%) were married, 133(49.6%) were single and 4(1.5%) were divorced. 39(14.6%) had only primary level of education, 142(52.6%) secondary, 67(25.0%) tertiary and 21(7.8%) had no formal education. 64(23.9%) had utilized dental service, while 204(76.1%) had not visited a dental clinic (had not utilized dental service). The common reason for dental service utilization was dental pain. The predominant occupation was farming and small scale business/trading. P= 0.038. Conclusion: Dental health was neglected by a vast majority of the participants, The poor utilization of dental service by the respondents could be due to poor awareness, absence of dental insurance, financial constraints , lack of perceived need for dental care, economic difficulties ,socio-demographic factors such as age, sex, educational attainment, and household income. Effort needs to be applied to create better awareness and possibly increase dental clinic attendance. Emphasis should be placed on benefits of utilizing preventive dental services rather than only curative through dental awareness programms.

scholarly journals COVID-19 and Its Implications in Dental Care

2020 ◽  
pp. 53-57
Author(s):  
H. Inegbenosun ◽  
E. P. Ofiri ◽  
C. C. Azodo
Keyword(s):  
Public Health ◽  
Low Income ◽  
Dental Care ◽  
Public Health Problem ◽  
Low Income Countries ◽  
Dental Procedures ◽  
The World ◽  
Huge Impact ◽  
Dental Practices ◽  
The Government

COVID-19 was first reported in Wuhan, Hubei Province of China a few months ago (December 2019) and had since become a major challenging public health problem for not only China but also many countries around the world. It was on March 11, 2020, characterized by WHO as a pandemic. The pandemic so far has killed more than 526,465 people and infected more than 11,046,917 people around the world as of 05 July 2020. Nigeria currently has 28,167 confirmed COVID-19 cases with 11,462 (40%) discharged, 16,071 (57%) currently receiving treatment at designated facilities across the country and unfortunately 634 (3%) deaths as at the time of writing this manuscript. As far as the authors are aware, there are little or no work carried out on the implications of COVID-19 on dental practices in Nigeria. Recently, COVID-19 was identified in saliva of infected patients and so transmission via aerosols and splatter generated during dental procedures is sure. To limit exposure, there was a need to avoid scheduling patients except for emergency dental care during this outbreak. This limitation on activities of the dental sector has a very huge impact on the economy of the sector as it has already resulted in serious monetary implications for dental practices worldwide. While dental practices in the high-income countries are getting help from their respective Government, those in the middle and low-income countries like Nigeria have been left to wallow in bankruptcy without support. The authors highly recommend that the Government of these neglected countries, step up and support dental practices that are on the brink of closing down due to the low turnout of patients to their practice during this outbreak.

scholarly journals Two-year supervised tooth brushing program evaluation in preschools in Southern Israel

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Dekel ◽  
S P Zusman ◽  
V Pikovsky ◽  
L Natapov
Keyword(s):  
Preschool Children ◽  
Dental Care ◽  
Dental Health ◽  
Dental Service ◽  
Tooth Brushing ◽  
Favorable Effect ◽  
Caries Experience ◽  
Dental Services ◽  
National Health Insurance Law ◽  
Carious Teeth

Abstract Background Dental care for children was included into National Health Insurance Law in 2010 and eligibility age went up gradually to 18 in 2019, providing universal dental care. As a part of dental care reform, community based preventive School Dental Services were extended to preschool children. School dental service (SDS), funded entirely by the State, was extended to younger ages providing supervised tooth brushing module. The national supervised teeth brushing program (STBP) was first implemented in 2015-2016 amongst 3-4 year old children attending 600 nurseries in Israel. Due to the program’s success, it was gradually extended to more nurseries in low socio economic regions across the country, reaching 2200 settings in 2019. The objective of this study was to assess dental health among preschool children participating in the program during the last two years, comparing to those who did not. Methods Participant and non-participant kindergartens were randomly selected in Jewish and Bedouin Arab towns in the Southern district matched according to SES level. DMFT index measuring mean number of decayed, missing and filled teeth was recorded among preschool 5 years-old children. Results 283 children were examined, 157of them Jewish (86 participants in STBP, 71 non-participants) and 126 Bedouins (59 vs 67 respectively). Mean untreated carious teeth (d) was 1.15 vs 1.8 for Jews and 3.22 vs 3.9 for Bedouins. Percent of treated teeth within total caries experience index (f/dmf) was higher in tooth brushing group: 37% vs. 29% for Jews and 23% vs. 8% for Bedouins. Key messages Supervised tooth brushing shows favorable effect. Less carious teeth and more treated caries were recorded in STBP group.

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