1
|
Melo P, Frey-Furtado L, Correia D, Listl S, Lorenz M, Bostanci N, Azevedo Á, Pereira ML. Pressing issues for oral care quality improvement: findings from the EU DELIVER project. BMC Public Health 2024; 24:2173. [PMID: 39134993 PMCID: PMC11318123 DOI: 10.1186/s12889-024-19707-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND While oral health often takes a backseat to other health domains, it silently affects nearly half of the Worldwide population. The DELIVER project, funded by the EU's Horizon Europe program, seeks to develop a blueprint model for improving the quality of oral health care for everyone. METHODS Applying the Nominal Group Technique (NGT), 17 stakeholders from various backgrounds participated in identifying pressing issues for oral care quality improvement across practice, community, and policy levels. RESULTS The results revealed significant differences at the different levels, with accessibility emerging as a prominent issue, encompassing affordability, availability, and acceptability of oral healthcare services. CONCLUSIONS These findings emphasizes the need for policy reforms, increased investments, and a shift towards preventive and patient-centered dental care practices. It highlights the importance of collaborative efforts with multi-stakeholders and prioritizing pressing issues on a multi-level to drive positive change in improving oral care quality.
Collapse
Affiliation(s)
- Paulo Melo
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto, 4050-600, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Faculdade de Medicina Dentária da Universidade do Porto, Rua Dr. Manuel Pereira da Silva, Porto, 4200-393, Portugal
| | - Leonor Frey-Furtado
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto, 4050-600, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Faculdade de Medicina Dentária da Universidade do Porto, Rua Dr. Manuel Pereira da Silva, Porto, 4200-393, Portugal
| | - Daniela Correia
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto, 4050-600, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Stefan Listl
- Department of Dentistry-Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences (RIHS), Nijmegen, Gelderland, The Netherlands
- Heidelberg Institute of Global Health - Section for Oral Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Michael Lorenz
- Heidelberg Institute of Global Health - Section for Oral Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Álvaro Azevedo
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto, 4050-600, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Faculdade de Medicina Dentária da Universidade do Porto, Rua Dr. Manuel Pereira da Silva, Porto, 4200-393, Portugal
| | - Maria Lurdes Pereira
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto, 4050-600, Portugal.
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
- Faculdade de Medicina Dentária da Universidade do Porto, Rua Dr. Manuel Pereira da Silva, Porto, 4200-393, Portugal.
| |
Collapse
|
2
|
Towards a new paradigm for ‘journal quality’ criteria: a scoping review. Scientometrics 2022. [DOI: 10.1007/s11192-022-04520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
3
|
Choi SE, Kalenderian E, Normand S. Measuring the quality of dental care among privately insured children in the United States. Health Serv Res 2022; 57:137-144. [PMID: 34327703 PMCID: PMC8763286 DOI: 10.1111/1475-6773.13713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To examine whether quality of dental care varies by age and over time and whether community-level characteristics explain these patterns. DATA SOURCE Deidentified medical and dental claims from a commercial insurer from January 2015 to December 2019. STUDY DESIGN A retrospective cohort study. The primary outcome was a composite quality score, derived from seven dental quality measures (DQMs), with higher values corresponding to better quality. Hierarchical regression models identified person- and zip code-level factors associated with the quality. DATA COLLECTION/EXTRACTION METHODS Continuously enrolled US dental insurance beneficiaries younger than 21 years of age. PRINCIPAL FINDINGS Quality was assessed for 4.88 million person-years covering 1.31 million persons. Overall quality slightly improved over time, mostly driven by substantial improvements among children aged 0-5 years by 0.153 points/year (95% confidence interval [CI]:0.151, 0.156). Quality was poorest and declined over time among adolescents with only 20.5% of DQMs met as compared to 42.6% among aged 0-5 years in 2019. Dental professional shortage, median household income, percentages of African Americans, unemployed, and less-educated populations at the zip code level were associated with the composite score. CONCLUSION Quality of dental care among adolescents remains low, and place of residence influenced the quality. Increasing the supply of dentists and oral health promotion strategies targeting adolescents and low-performing localities should be explored.
Collapse
Affiliation(s)
- Sung Eun Choi
- Department of Oral Health Policy and EpidemiologyHarvard School of Dental MedicineBostonMassachusettsUSA
| | - Elsbeth Kalenderian
- Department of Oral Health Policy and EpidemiologyHarvard School of Dental MedicineBostonMassachusettsUSA
- Department of Preventive and Restorative Dental SciencesUniversity of California at San Francisco, School of DentistrySan FranciscoCaliforniaUSA
- Department of Dental Management Sciences School of DentistryUniversity of PretoriaPretoriaSouth Africa
| | - Sharon‐Lise Normand
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
- Department of BiostatisticsHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| |
Collapse
|
4
|
Goes PSAD, Biazevic MG, Celeste RK, Moyses S. Secondary dental care quality in Brazil: What we are talking about? Community Dent Oral Epidemiol 2021; 50:1-3. [PMID: 34967964 DOI: 10.1111/cdoe.12724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Paulo Sávio Angeiras de Goes
- Department of clinical and preventive dentistry, Federal University of Pernambuco, Recife, Brazil.,Olinda Medical School, Olinda, Brazil
| | | | - Roger Keller Celeste
- Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Samuel Moyses
- School of Dentistry, Pontificia Universidade Católica do Paraná (PUC-PR), Curitiba-PR, Brazil
| |
Collapse
|
5
|
Chung PC, Chan TC. Association between local spatial accessibility of dental care services and dental care quality. BMC Oral Health 2021; 21:582. [PMID: 34789214 PMCID: PMC8600821 DOI: 10.1186/s12903-021-01943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
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.
Collapse
Affiliation(s)
- Ping-Chen Chung
- Department of Dentistry, Puzi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, 128 Academia Road, Section 2, Taipei, Taiwan. .,Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
6
|
Crisan EL, Covaliu BF, Chis DM. A Systematic Literature Review of Quality Management Initiatives in Dental Clinics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11084. [PMID: 34769604 PMCID: PMC8582852 DOI: 10.3390/ijerph182111084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/16/2021] [Accepted: 10/17/2021] [Indexed: 12/17/2022]
Abstract
By considering the recently proposed definitions and metrics, oral healthcare quality management (OHQM) emerges as a distinct field in the wider healthcare area. The goal of this paper is to systematically review quality management initiatives (QMIs) implementation by dental clinics. The research methodology approach is a review of 72 sources that have been analyzed using the Context-Intervention-Mechanism-Outcome Framework (CIMO). The analysis identifies five mechanisms that explain how quality management initiatives are implemented by dental clinics. The simplest QMIs implementations are related to (1) overall quality. The next ones, in terms of complexity, are related to (2) patient satisfaction, (3) service quality, (4) internal processes improvement, and (5) business outcomes. This paper is the first attempt to provide a critical review of this topic and represents an important advancement by providing a theoretical framework that explains how quality management is implemented by practitioners in this field. The results can be used by scholars for advancing their studies related to this emerging research area and by healthcare managers in order to better implement their quality management initiatives.
Collapse
Affiliation(s)
- Emil Lucian Crisan
- Faculty of Economics and Business Administration, Department of Management, Babes-Bolyai University, 400591 Cluj-Napoca, Romania;
| | - Bogdan Florin Covaliu
- Faculty of Medicine, Department of Community Medicine, Public Health and Management, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400337 Cluj-Napoca, Romania
| | - Diana Maria Chis
- Faculty of Economics and Business Administration, Department of Finance, Babes-Bolyai University, 400591 Cluj-Napoca, Romania;
| |
Collapse
|
7
|
Benzian H, Listl S. [Global oral health in the international health policy spotlight-challenges and new opportunities for sustainable improvement]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:871-878. [PMID: 34100957 PMCID: PMC8185487 DOI: 10.1007/s00103-021-03353-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/12/2021] [Indexed: 12/02/2022]
Abstract
Orale Erkrankungen sind ein signifikantes globales Gesundheitsproblem über alle Länder und Bevölkerungsgruppen hinweg. Mit fast 3,5 Mrd. Erkrankungsfällen (2017) sind so viele Menschen betroffen wie von keiner anderen Krankheitsgruppe. Die Haupterkrankungen sind unbehandelte Karies der bleibenden oder der Milchzähne, fortgeschrittene Parodontopathien, Zahnlosigkeit sowie Karzinome der Mundhöhle und Lippen. Bei weitgehend unverändert hoher globaler Prävalenz erhöhen durch Bevölkerungswachstum bedingte stark steigende Fallzahlen den Druck auf schwache oder überlastete Gesundheitssysteme, insbesondere in Ländern der unteren und mittleren Einkommensgruppen. Dennoch wird der Mundgesundheit in vielen Ländern nur unzureichende Priorität eingeräumt und sie erhält als wichtiges Thema im gesundheitspolitischen Diskurs der deutschen und globalen Akteure nach wie vor wenig Aufmerksamkeit. Eine der fundamentalen Herausforderungen ist dabei die Gewährleistung eines allgemeinen und fairen Zugangs zu adäquater universeller Basisgesundheitsversorgung für alle Menschen ohne Verursachung von finanziellen Härten (Universal Health Coverage). Dieser Beitrag gibt einen einführenden Überblick über die globalen Trends der weltweiten Krankheitslast der oralen Haupterkrankungen, die von starken Ungleichheiten geprägt sind. Verbesserungsansätze aus der bevölkerungsweiten Risikoreduktion und Prävention, der Versorgungsplanung sowie gesundheitspolitische Lösungen werden kurz vorgestellt. Dabei werden die im internationalen Diskurs wichtigen Themen angesprochen und die im Rahmen einer Lancet-Artikelserie zur globalen Mundgesundheit aus dem Jahr 2019 entwickelten Reformbereiche besprochen. Schließlich werden neue Initiativen diskutiert sowie Empfehlungen für die deutsche und internationale gesundheitliche Entwicklungspolitik gegeben, die in den kommenden Jahren die Situation der globalen Mundgesundheit entscheidend verbessern könnten.
Collapse
Affiliation(s)
- Habib Benzian
- Department of Epidemiology & Health Promotion, WHO Collaborating Center for Quality Improvement & Evidence-based Dentistry, College of Dentistry, New York University, New York, USA
| | - Stefan Listl
- Lehrstuhl für Quality and Safety of Oral Health Care, Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Niederlande. .,Sektion Translationale Gesundheitsökonomie, Universitätsklinikum Heidelberg, Poliklinik für Zahnerhaltungskunde, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| |
Collapse
|
8
|
Hugo FN, Kassebaum NJ, Marcenes W, Bernabé E. Role of Dentistry in Global Health: Challenges and Research Priorities. J Dent Res 2021; 100:681-685. [PMID: 33541197 PMCID: PMC8217900 DOI: 10.1177/0022034521992011] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Despite some improvements in the oral health of populations globally, major problems remain all over the planet, most notably among underprivileged communities of low- and middle-income countries but also in high-income countries. Furthermore, essential oral health care has been a privilege, instead of a right, for most individuals. The release of the Lancet issue on oral health in July 2019 built up some momentum and put oral conditions and dental services in the limelight. Yet, much work is still needed to bridge the gap between dental research and global health and get oral health recognized as a population health priority worldwide. Using the framework proposed by Shiffman, we argue that a global health network for oral health must be harnessed to influence global health policy and drive health system reform. We have identified challenges around 4 key areas (problem definition, positioning, coalition building, and governance) from our experience working in the global health arena and with collaborators in multidisciplinary teams. These challenges are outlined here to validate them externally but also to call the attention of interested players inside and outside dentistry. How well our profession addresses these challenges will shape our performance during the Sustainable Development Goals era and beyond. This analysis is followed by a discussion of fundamental gaps in knowledge, particularly in 3 areas of oral health action: 1) epidemiology and health information systems; 2) collection, harmonization, and rigorous assessment of evidence for prevention, equity, and treatment; and 3) optimal strategies for delivering essential quality care to all who need it without financial hardship.
Collapse
Affiliation(s)
- F N Hugo
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - N J Kassebaum
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - W Marcenes
- Affordable Health initiative, London, UK
| | - E Bernabé
- Dental Public Health Group, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| |
Collapse
|
9
|
Birch S, Ahern S, Brocklehurst P, Chikte U, Gallagher J, Listl S, Lalloo R, O'Malley L, Rigby J, Tickle M, Tomblin Murphy G, Woods N. Planning the oral health workforce: Time for innovation. Community Dent Oral Epidemiol 2020; 49:17-22. [PMID: 33325124 PMCID: PMC7839544 DOI: 10.1111/cdoe.12604] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/01/2020] [Accepted: 11/09/2020] [Indexed: 12/19/2022]
Abstract
The levels and types of oral health problems occurring in populations change over time, while advances in technology change the way oral health problems are addressed and the ways care is delivered. These rapid changes have major implications for the size and mix of the oral health workforce, yet the methods used to plan the oral health workforce have remained rigid and isolated from planning of oral healthcare services and healthcare expenditures. In this paper, we argue that the innovation culture that has driven major developments in content and delivery of oral health care must also be applied to planning the oral health workforce if we are to develop ‘fit for purpose’ healthcare systems that meet the needs of populations in the 21st century. An innovative framework for workforce planning is presented focussed on responding to changes in population needs, service developments for meeting those needs and optimal models of care delivery.
Collapse
Affiliation(s)
- Stephen Birch
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, Queensland, Australia.,Centre for Health Economics, University of Manchester, Manchester, UK
| | - Susan Ahern
- Oral Health Services Research Centre, Cork University Dental School & Hospital, University College Cork, Cork, Ireland
| | | | - Usuf Chikte
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Jennifer Gallagher
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Stefan Listl
- Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University, Nijmegen, The Netherlands
| | - Ratilal Lalloo
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Lucy O'Malley
- School of Dentistry, University of Manchester, Manchester, UK
| | - Janet Rigby
- WHO/PAHO Collaborating Centre on Health Workforce Planning & Research, Dalhousie University, Halifax, NS, Canada
| | - Martin Tickle
- School of Dentistry, University of Manchester, Manchester, UK
| | - Gail Tomblin Murphy
- WHO/PAHO Collaborating Centre on Health Workforce Planning & Research, Dalhousie University, Halifax, NS, Canada
| | - Noel Woods
- Centre for Policy Studies, Cork University Business School, University College Cork, Cork, Ireland
| |
Collapse
|
10
|
Righolt AJ, Duijster D, van der Wees PJ, Listl S, Smits KPJ. Dutch oral health care quality measures: a modified Delphi study. Int Dent J 2020; 70:277-286. [PMID: 32285939 PMCID: PMC7497121 DOI: 10.1111/idj.12566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives: Quality measures offer opportunities for evaluation and improvement of the quality of oral health care. This study describes the development of a core set of oral health care quality measures for adults in the Netherlands, which can be used in dental practice. Materials and methods: A comprehensive two-stage approach was used, consisting of: (1) identification of an initial set of measures based on appraised literature; and (2) a four-round modified RAND/UCLA Appropriateness Method to establish measures that are relevant, appropriate and important to oral health care. Measures were rated anonymously on a nine-point Likert scale, ranging from 1 (lowest rating) to 9 (highest rating), followed by a group discussion to reach consensus. Multiple key stakeholder groups in the Dutch oral health care field were involved in the Delphi rounds, including dental professionals, scientists and representatives from Dutch oral health care organisations. Results: The study resulted in a core set of 13 oral health care quality measures. The measures cover domains related to oral disease outcomes, oral treatment and preventive services, patient experiences, patient safety, and organisational aspects of oral health care. In addition, the study led to the identification of 49 structural aspects of oral health care that are important to measure. Discussion: To our knowledge, this is the first study combining appraised literature from a systematic review and a rigorous multi-stage procedure with extensive stakeholder involvement to develop a core set of oral health care quality measures. In the next phase, the measures will be tested on feasibility, reliability, and will be piloted and implemented in practice.
Collapse
Affiliation(s)
- Amy J Righolt
- Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University - Radboudumc (RIHS), Nijmegen, The Netherlands
| | - Denise Duijster
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Philip J van der Wees
- Radboud Institute for Health Sciences - IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stefan Listl
- Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University - Radboudumc (RIHS), Nijmegen, The Netherlands.,Medical Faculty, Department of Conservative Dentistry, Section for Translational Health Economics, Heidelberg University, Heidelberg, Germany
| | - Kirsten P J Smits
- Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University - Radboudumc (RIHS), Nijmegen, The Netherlands
| |
Collapse
|