scholarly journals Association between local spatial accessibility of dental care services and dental care quality

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ping-Chen Chung ◽  
Ta-Chien Chan

Abstract Background The aim of our study was to evaluate the allocation of dental resources and explore access to dental care in Taiwan. In addition, we tried to understand the spatiotemporal characteristics of dental care quality and analyze the relationship between dental care quality and areas with deficiencies in dental resources. Methods The study used a two-step floating catchment area to calculate the dental resources accessibility and explore the spatiotemporal distributions of dental care quality. The association between dental care quality and spatial accessibility was analyzed using a spatial error model. Results Most areas with deficient dental resources and lower dental care quality were remote townships, agricultural towns, or aging towns with spatial clustering. The quality of children's preventive dental care had increased over time. Most highly urbanized areas had higher dental care quality. The quality of some dental care types such as children's preventive care and full-mouth calculous removal was associated with higher accessibility. Conclusions Understanding the spatiotemporal distribution of both dental care accessibility and quality can assist in allocation of dental care resources. Adequate dental resources may elevate dental care quality. Suggestions include policies to balance dental resources and routinely monitor improvement in areas with deficient dental care.

AAOHN Journal ◽  
2009 ◽  
Vol 57 (9) ◽  
pp. 374-380 ◽  
Author(s):  
Hasanat Alamgir ◽  
Olivia Wei Li ◽  
Erin Gorman ◽  
Catherine Fast ◽  
Shicheng Yu ◽  
...  

Ceiling lifts have been introduced into health care settings to reduce manual patient lifting and thus occupational injuries. Although growing evidence supports the effectiveness of ceiling lifts, a paucity of research links indicators, such as quality of patient care or patient perceptions, to the use of these transfer devices. This study explored the relationship between ceiling lift coverage rates and measures of patient care quality (e.g., incidence of facility-acquired pressure ulcers, falls, urinary infections, urinary incontinence, and assaults [patient to staff] in acute and long-term care facilities), as well as patient perceptions of satisfaction with care received while using ceiling lifts in a complex care facility. Qualitative semi-structured interviews were used to generate data. A significant inverse relationship was found between pressure ulcer rates and ceiling lift coverage; however, this effect was attenuated by year. No significant relationships existed between ceiling lift coverage and patient outcome indicators after adding the “year” variable to the model. Patients generally approved of the use of ceiling lifts and recognized many of the benefits. Ceiling lifts are not detrimental to the quality of care received by patients, and patients prefer being transferred by ceiling lifts. The relationship between ceiling lift coverage and pressure ulcer rates warrants further investigation.


2014 ◽  
Vol 3 (6) ◽  
pp. 20 ◽  
Author(s):  
Ezekiel Taiwo Adebayo ◽  
Bola Ayodele Adesina ◽  
Lilian Ejije Ahaji ◽  
Nurudeen Ayoola Hussein

Dental care services are available in many urban communities worldwide where discerning and sophisticated clients expect quality care. Many available studies evaluated satisfaction rather than quality of dental care; others did not reveal the patients’ perception of gaps in the quality of care. Service quality (SERVQUAL) tool assesses quality of service based on the dimensions of tangibles, reliability, responsiveness, assurance and empathy as described by Parasuraman et al. (1985). The aim of this study was to assess the gaps in quality of dental care in a Nigerian government owned dental clinic using an unweighted SERVQUAL tool to determine the difference between expectations and perceptions of patients. Consenting patients seen during the study period were given a 32-items questionnaire divided equally between expectations and perception of quality of dental care services received. Out of 112 questionnaires analysed, patients had the most expectation for neatness (4.69 ± 0.85) and least for pain free treatment (3.76 ± 1.16). Highest perception was for knowledgeable clinic staff (4.34 ± 0.71) while support to enable staff work well was the least perceived quality (3.73 ± 0.86). Overall, among the 5 dimensions of quality, there were marked statistically significant quality gaps in assurance (p = .0001) and tangibles (p = .0006). This study showed that patients in a Nigerian government-owned dental clinic, there is need for greater attention to be paid to assurance, tangibles and reliability dimensions of service quality to improve patient perceptions.


2020 ◽  
Vol 25 (2) ◽  
pp. 533-540
Author(s):  
Bruna Mara Ruas ◽  
Lia Silva Castilho ◽  
Natália Cristina Ruy Carneiro ◽  
Natália Mendes de Matos Cardoso ◽  
Augusto Barbosa Reis ◽  
...  

Abstract The present study aimed to analyze factors associated with access of dental care services by Brazilian hemodialysis patients. A cross-sectional study was carried out with 467 hemodialysis patients aging from 19 to 90 years in two renal therapy centers located in the cities of Contagem and Belo Horizonte, Southeastern Brazil. Data were collected through an oral clinical examination of the patients and the application of a structured questionnaire. The dependent variable was the access to dental care, measured by the question "Have you consulted with a dentist in last six months?". The mean age of participants was 49.9 years. The average number of teeth present in the mouth was 19.3. An average of 1.5 teeth with dental caries cavities lesion was diagnosed among hemodialysis patients. One-third of the sample had gone to the dentist in the last six months (27.8%). The access to dental care was associated with formal education (OR = 1.5 [1.1-2.4]), professional advising to consult with a dentist (OR = 2.1 [1.2-3.8]) and prevalence of dental caries (OR = 2.1 [1.3-3.2]). Hemodialysis patients with eight or more years of formal education, who received professional advising to consult with a dentist and without dental caries cavities had higher chances obtaining access to dental care.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S606-S607
Author(s):  
Zhiqiu Ye ◽  
Bei Wu

Abstract Nursing home (NH) residents are disproportionately affected by poor oral health. But little we known about the root causes. We analyzed the 2000-2016 national inspection survey data for all certified-NHs (n=248,975 facility-years). Dental care performance was measured by two designated deficiency citations. Generalized estimating equation models were used to predict if the NH facility and market characteristics were associated with low performance. The rates of deficiency citation tripled from 1.2% in 2000 to 3.4% in 2016 (p<0.001) with substantial variation across states. NHs with more minority residents and poorer resources (higher share of Medicaid and lack of registered nurse), and NHs with high competing priorities (larger, for profit, chain-affiliated and urban locations) were more likely to receive deficiency citations. Residents in these facilities are at greater risks of poor oral health. This presentation will provide discussion on relevant policy and practice to improve dental care quality in nursing homes.


2019 ◽  
Vol 28 (9) ◽  
pp. 706-713 ◽  
Author(s):  
Jackie Bridges ◽  
Peter Griffiths ◽  
Emily Oliver ◽  
Ruth M Pickering

BackgroundExisting evidence indicates that reducing nurse staffing and/or skill mix adversely affects care quality. Nursing shortages may lead managers to dilute nursing team skill mix, substituting assistant personnel for registered nurses (RNs). However, no previous studies have described the relationship between nurse staffing and staff–patient interactions.SettingSix wards at two English National Health Service hospitals.MethodsWe observed 238 hours of care (n=270 patients). Staff–patient interactions were rated using the Quality of Interactions Schedule. RN, healthcare assistant (HCA) and patient numbers were used to calculate patient-to-staff ratios. Multilevel regression models explored the association between staffing levels, skill mix and the chance of an interaction being rated as ‘negative’ quality, rate at which patients experienced interactions and total amount of time patients spent interacting with staff per observed hour.Results10% of the 3076 observed interactions were rated as negative. The odds of a negative interaction increased significantly as the number of patients per RN increased (p=0.035, OR of 2.82 for ≥8 patients/RN compared with >6 to <8 patients/RN). A similar pattern was observed for HCA staffing but the relationship was not significant (p=0.056). When RN staffing was low, the odds of a negative interaction increased with higher HCA staffing. Rate of interactions per patient hour, but not total amount of interaction time, was related to RN and HCA staffing levels.ConclusionLow RN staffing levels are associated with changes in quality and quantity of staff–patient interactions. When RN staffing is low, increases in assistant staff levels are not associated with improved quality of staff–patient interactions. Beneficial effects from adding assistant staff are likely to be dependent on having sufficient RNs to supervise, limiting the scope for substitution.


2017 ◽  
Vol 9 (2) ◽  
pp. 138-147 ◽  
Author(s):  
Ali Kazemi ◽  
Petri Kajonius

Purpose National Board of Health and Welfare claims that the quality of elderly care services differ considerably between municipalities in Sweden. This study aims to analyze to what extent these variations can be accounted for by the older person’s municipality affiliation (i.e. receiving elderly care in a certain municipality). Design/methodology/approach Addressing this issue, national survey data from 78,538 older respondents receiving elderly care services in Sweden were analyzed using multilevel modeling (MLM). Findings The results showed that municipality affiliation only marginally explained the variance in satisfaction with care, i.e. its variations were larger within than between municipalities. Instead, user-oriented care accounted for the variation in satisfaction with care. Specifically, the way the care workers behave toward the older person proved to be much more crucial for satisfaction with care than municipality affiliation. Moreover, random effects analyses revealed that the effects of user-oriented care on satisfaction with care varied across municipalities. Care setting (i.e. home care or nursing home) only marginally accounted for its variance. Practical implications Developing care quality should start and primarily be discussed at the interpersonal care level, and not, as is customary, at the municipality level. Originality/value The present research is the first in its kind to quantitatively investigate the sources of variation in perceived quality of Swedish elderly care using MLM.


2014 ◽  
Vol 22 (2) ◽  
pp. 51-61 ◽  
Author(s):  
Catherine Mangan ◽  
Robin Miller ◽  
Jeremy Cooper

Purpose – The purpose of this paper is to explore the relationship between general practitioners (GPs) and social care professionals by reflecting on a project (the Home Truths project) which sought to improve joint working between general practice and social care though an action-research process. Design/methodology/approach – iMPOWER's Home Truths project involved gathering local data regarding joint working in local areas and using this data as a catalyst for change. The Institute of Local Government Studies and the Health Services Management Centre at the University of Birmingham were asked to act as a critical friend to the project. This involved supporting the design of the data collection, offering advice on the process and to carrying out a short evaluation of the impact of the first wave. The paper reflects on the collected data from the sites and information from the impact evaluation. Findings – The paper highlights the poor quality of the relationship between GPs and social workers. Findings that illustrate this include GPs’ poor knowledge of social care services; a perception that social care services were of poor quality and rating the quality of their relationships with social workers as poor. However GPs felt that knowing more about social care could help prevent their patients going into residential care earlier than necessary and wanted to work more closely with social care to exploit the benefits and opportunities. The interventions that have been put in place to try and improve relationships focus on the day-to-day working lives of the professionals rather than attempting to introduce new initiatives. Research limitations/implications – The response rate from GPs in the areas was low (average response rate was 10 per cent in each area) and it may be that only those GPs who are interested in working with social care responded. The initiatives that have been developed appear to be reasonable responses to the issues identified. However, a lack of discrete outcomes through which to measure improvement will make it difficult to demonstrate the impact of the interventions. Originality/value – This paper underlines that despite many years of policy makers promoting better integration, the relationship between the key gate-keepers within the health and social care systems is still poor. The findings from the Home Truths surveys and action plans has gone some way to address the gap identified in the evidence base about the relationships between GPs and social workers.


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