Toward More Patient-Centered and Prevention-Oriented Oral Health Care

2016 ◽  
Vol 2 (1) ◽  
pp. 5-9 ◽  
Author(s):  
H. Leggett ◽  
D. Duijster ◽  
G.V.A. Douglas ◽  
K. Eaton ◽  
G.J.M.G. van der Heijden ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Disease Prevention ◽  
Care Delivery ◽  
Health Care Systems ◽  
Oral Care ◽  
Oral Health Care ◽  
Patient Centered ◽  
Care Systems ◽  
European Union Member States

ADVOCATE (Added Value for Oral Care) is a project funded by the European Commission’s Horizon 2020 program, which aims to develop strategies for a system transition toward more patient-centered and prevention-oriented oral health care delivery within health care systems. This system should balance the restorative and preventive approaches in dental and oral health care. ADVOCATE is a partnership among 6 European Union member states, which involves collaboration among universities, state-funded health care providers, and private insurance companies in Denmark, Germany, Hungary, Ireland, the Netherlands, the United Kingdom, and Aridhia, a biomedical informatics company based in Scotland. There are 6 interrelated work packages, which aim to address the following objectives: 1) in-depth evaluation of oral health care systems in European Union member states to identify best system designs for oral disease prevention, 2) development of a set of measures to provide information on oral care delivery and oral health outcomes, 3) evaluation of a feedback approach in dental practice that aims to facilitate a change toward preventive oral health care delivery, and 4) economic evaluation of strategies to promote preventive oral health care and development of policy recommendations for oral health care systems. The project is novel in its use of data that are routinely collected by health insurance organizations, as well as the engagement of key stakeholders from dental teams, insurers, patients, and policy makers in guiding the development and progress of the project. This article outlines in detail the objectives and research methodology of the ADVOCATE project and its anticipated impact. Knowledge Transfer Statement: This commentary describes the development of policy options to promote a greater focus on disease prevention in general dental practice. The approach builds on identifying the comparative effectiveness of alternative incentive schemes, as well as methods to monitor clinical and patient-derived measures of success in creating health for patients. The article describes the development and application of the measures and the evaluation of their success in orienting clinical practice more toward disease prevention.

scholarly journals A Consensus-Based Set of Measures for Oral Health Care

2017 ◽  
Vol 96 (8) ◽  
pp. 881-887 ◽  
Author(s):  
F. Baâdoudi ◽  
A. Trescher ◽  
D. Duijster ◽  
N. Maskrey ◽  
F. Gabel ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Routine Data ◽  
Oral Health Care ◽  
Care Providers ◽  
Patient Centered ◽  
Dental Practitioners ◽  
Care Systems

Increasingly more responsive and accountable health care systems are demanded, which is characterized by transparency and explicit demonstration of competence by health care providers and the systems in which they work. This study aimed to establish measures of oral health for transparent and explicit reporting of routine data to facilitate more patient-centered and prevention-oriented oral health care. To accomplish this, an intermediate objective was to develop a comprehensive list of topics that a range of stakeholders would perceive as valid, important, and relevant for describing oral health and oral health care. A 4-stage approach was used to develop the list of topics: 1) scoping of literature and its appraisal, 2) a meeting of experts, 3) a 2-stage Delphi process (online), and 4) a World Café discussion. The aim was to create consensus through structured conversations via a range of stakeholders (general dental practitioners, patients, insurers, and policy makers) from the Netherlands, Germany, the United Kingdom, Ireland, Hungary, and Denmark. The study was part of the ADVOCATE project, and it resulted in a list of 48 topics grouped into 6 clusters: 1) access to dental care, 2) symptoms and diagnosis, 3) health behaviors, 4) oral treatments, 5) oral prevention, and 6) patient perception. All topics can be measured, as they all have a data source with defined numerators and denominators. This study is the first to establish a comprehensive and multiple-stakeholder consented topic list designed for guiding the implementation of transparent and explicit measurement of routine data of oral health and oral health care. Successful measurement within oral health care systems is essential to facilitate learning from variation in practice and outcomes within and among systems, and it potentiates improvement toward more patient-centered and prevention-oriented oral health care.

Oral Health in Rheumatoid Arthritis: Listening to Patients

2021 ◽  
pp. 238008442110126
Author(s):  
J.L.P. Protudjer ◽  
C. Billedeau ◽  
K. Hurst ◽  
R. Schroth ◽  
C. Stavropoulou ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Care ◽  
Oral Health ◽  
Periodontal Disease ◽  
Health Knowledge ◽  
Care Delivery ◽  
Oral Care ◽  
Oral Health Care ◽  
Personal Hygiene ◽  
Health Maintenance

Introduction: Rates of periodontal disease and tooth loss are increased in individuals with rheumatoid arthritis (RA). Understanding factors that contribute to the increased burden of periodontal disease in RA is critical to improving oral health and arthritis outcomes. Objectives: To determine the perceptions held by people with RA relating to their oral health, to identify patient-centered priorities for oral health research, and to inform optimal strategies for delivering oral health knowledge. Methods: Semistructured interviews were conducted with patients with RA. Recorded interview transcripts were iteratively reviewed to reveal surface and latent meaning and to code for themes. Constructs were considered saturated when no new themes were identified in subsequent interviews. We report themes with representative quotes. Results: Interviews were conducted with 11 individuals with RA (10 women [91%]; mean age, 68 y), all of whom were taking RA medication. Interviews averaged 19 min (range, 8 to 31 min) and were mostly conducted face-to-face. Three overall themes were identified: 1) knowledge about arthritis and oral health links; 2) oral health care in RA is complicated, both in personal hygiene practices and in professional oral care; and 3) poor oral health is a source of shame. Participants preferred to receive oral health education from their rheumatologists or dentists. Conclusions: People with RA have unique oral health perceptions and experience significant challenges with oral health care due to their arthritis. Adapting oral hygiene recommendations and professional oral care delivery to the needs of those with arthritis are patient priorities and are required to improve satisfaction regarding their oral health. Knowledge Translation Statement: Patients living with long-standing rheumatoid arthritis described poor oral health–related quality of life and multiple challenges with maintaining optimal oral health. Study findings indicate a need for educational materials addressing oral health maintenance for patients with rheumatic diseases and their providers.

scholarly journals A review on oral health care in four different health care systems

2020 ◽  
Author(s):  
Mario Brondani ◽  
Kavita Mathu-Muju ◽  
Pia Skott ◽  
Gunilla Sandborgh-Englund ◽  
Fernando N Hugo ◽  
...  
Keyword(s):  
Health Care ◽  
New Zealand ◽  
Oral Health ◽  
Health Outcomes ◽  
Service Utilization ◽  
Health Care Systems ◽  
Oral Health Care ◽  
Publicly Funded ◽  
Care Systems ◽  
Oral Health Outcomes

Abstract Background : A universal approach to oral health is said to improve oral health outcomes, but research has shown mixed results. This study aimed at critically reviewing the literature available on the oral health care systems of four countries in terms of structure, scope, and delivery, along with their impact on oral health outcomes. Methods : A comparative literature review of the oral health care systems in Brazil, New Zealand, Canada, and Sweden was performed between August 2017 and January 2018 using PubMed/MEDLINE and the key words ‘universal’ OR ‘publicly funded’ AND ‘dental OR oral’ AND ‘care OR access’ AND ‘outcome’. This is a critical essay based on evidence available in the literature that was enriched by accounts from 12 key informants from these four countries. Results : All four countries provide some form of universal health care, but the administration, funding, and delivery of oral health care varied. Approximately 6% of oral health care expenditure in Canada is publicly funded. Brazil provides full publicly-funded oral health care at the point of use via salaried dental professionals, while Sweden offers a high-cost protection plan favouring those with greater needs, and New Zealand delivers publicly-funded oral health care to children up to their eighteenth birthday. With service utilization varying, 61% percent of Canadian children, 67% of Swedish children, 50% of Brazilian children, and 45% of New Zealand children are caries-free at age 12, while 6.4%, 0.8%, 6.5%, and 9.6% of adults between the ages of 20 and 79 years are edentulous, respectively. Conclusions : All countries have some form of publicly-funded oral health care, but vary in the way that the services are delivered, from salary-based providers to private-practice models. Service utilization and oral health outcomes differ in each country.

scholarly journals A review on oral health care oral health outcomes of four different health care systems

2019 ◽  
Author(s):  
Mario Brondani ◽  
Kavita Mathu-Muju ◽  
Pia Skott ◽  
Gunilla Sandborgh-Englund ◽  
Fernando N Hugo ◽  
...  
Keyword(s):  
Health Care ◽  
New Zealand ◽  
Oral Health ◽  
Health Outcomes ◽  
Service Utilization ◽  
Health Care Systems ◽  
Oral Health Care ◽  
Publicly Funded ◽  
Care Systems ◽  
Oral Health Outcomes

Abstract Background : A universal approach to oral health is said to improve oral health outcomes and lessen inequity, but research has shown mixed results. This study aimed at critically reviewing the oral health care systems of four countries in terms of structure, scope, and delivery, along with their impact on oral health outcomes. Methods : A comparative literature review of the oral health care systems in Brazil, New Zealand, Canada, and Sweden was performed between August 2017 and January 2018 using PubMed/MEDLINE and the key words ‘universal’ AND ‘dental OR oral’ AND ‘care OR access’ AND ‘outcome’. This is a critical essay based on evidence available in the literature and interactive conversations with 12 key informants from these countries. Results : All four countries provide some form of universal health care, but the administration, funding, and delivery of oral health care varied. Approximately 6% of oral health care expenditure in Canada is publicly funded. Brazil provides full publicly-funded oral health care at the point of use via salaried dental professionals, while Sweden offers a high-cost protection plan favouring those with greater needs, and New Zealand delivers publicly-funded oral health care to children–up to their eighteenth birthday. With service utilization varying, 61% of Canadian children, 67% of Swedish children, 50% of Brazilian children, and 45% of New Zealand children are caries-free at age 12, while 6.4%, 0.8%, 6.5%, and 9.6% of adults between the ages of 20 and 79 years are edentulous, respectively. Conclusions : All countries have some form of publicly-funded oral health care, but vary in the way that the services are delivered, from salary-based providers to private-practice models. Service utilization and oral health outcomes differ in each country.

Oral health care systems in developing and developed countries

2012 ◽  
Vol 60 (1) ◽  
pp. 98-109 ◽  
Author(s):  
Daniel Kandelman ◽  
Sophie Arpin ◽  
Ramon J. Baez ◽  
Pierre C. Baehni ◽  
Poul E. Petersen
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Care Systems ◽  
Developed Countries ◽  
Oral Health Care ◽  
Care Systems ◽  
Developing And Developed Countries

scholarly journals Universally funded oral health care and oral health outcomes

2019 ◽  
Author(s):  
Mario Brondani ◽  
Kavita Mathu-Muju ◽  
Pia Skott ◽  
Gunilla Sandborgh Englund ◽  
Fernando N Hugo ◽  
...  
Keyword(s):  
Health Care ◽  
New Zealand ◽  
Oral Health ◽  
Health Outcomes ◽  
Health Care Systems ◽  
Oral Health Care ◽  
Publicly Funded ◽  
Comparative Review ◽  
Care Systems ◽  
Oral Health Outcomes

Abstract Objectives To critically review the oral health care systems of four countries with a universal public health care system in terms of structure, scope and delivery and their impact on oral health outcomes. Methods A comparative review on the oral health care systems from Brazil, New Zealand, Canada and Sweden was performed between August 2017 and January 2018 using PubMed/MEDLINE and the key words ‘universal’ AND ‘dental OR oral’ AND ‘care OR access’ AND ‘outcome’. This is a critical essay based on evidence available in the literature and interactive conversations with key informants in all four countries. Results Although all four countries provide universal health care, the administration, funding and delivery of oral health care varied. About 6% of oral health care expenditure in Canada are publicly-funded. Brazil provides free oral health care at the point of use via salaried dental professionals, while Sweden offers a high-cost protection plan favouring those with greater needs, and New Zealand delivers free oral health care to children only up to their 18th birthday. With service utilization varying from 44% to more than 80%, sixty-one percent of Canadian children, 67% of Swedish children, 50% of Brazilian children and 45% of New Zealand children are caries-free at age 12 while 6.4%, 0.8%, 6.5%, and 9.6% of adults between the ages of 20 and 79 years are edentulous, respectively. Conclusions All countries have some form of publicly-funded oral health care, but a wide spectrum of salary-based and private-practice delivery models exists. Services utilization and oral health outcomes differ in each country.

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