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At least 217 records · Page 12Linked to original sources
PubMed1993

Orthodontic treatment standards in Norway.

The outcome of orthodontic treatment is reported for a sample of 220 patients treated by Norwegian specialist orthodontists. The outcome was assessed using objective measures. The indices can be used to identify differences not only between individual practitioners, but also health care systems. It can be confirmed that the Norwegian orthodontists are producing a high standard of orthodontic treatment, the malocclusion is on average reduced by 78 per cent.

Adult↗
PubMed1988

Item of service remuneration in general practice in the UK: what can we learn from dentists?

In response to the UK Government's proposal to increase the proportion of general practitioner income accruing from capitation payments the General Medical Services Committee of the British Medical Association has called for an extension of fee for item of service provision in general practice. In this paper the allocation of resources in primary care dentistry, where fee for service provision is currently used, is analysed in order to shed light on the debate. Since dentists' fees are set in accordance with average dentist time inputs, differences in cost per treatment course reflect differences in course content. Multiple regression techniques are used to estimate a cost per treatment course function. Using cross-sectional data for family practitioner committees in England and Wales for 1982 a significant negative correlation is found between cost per course and population per dentist after allowing for patient demand and need characteristics. A 10% decrease in population per dentist is associated with a 2.5% increase in cost per course. The observation cannot be explained by dentists rationing treatment in the presence of excess demand owning to the nature of the dentist contract. These results imply that in areas of greater supplies of dentists additional course content is being induced by dentists in order to maintain workloads. Hence although fee for service provision offers a financial incentive to increase service provision it offers no incentive to allocate services efficiently, that is in accordance with greatest need. The extension of fee for service provision in general medical practice would appear to be inconsistent with an objective of allocating scarce primary care resources in accordance with patient need.

Capitation Fee↗
PubMed2006

Challenges to dental access - England as a case study.

Access to dental services because of an insufficient workforce is a historic challenge faced by many developing countries. In recent years, however, it has become a major issue for many industrialized countries. The growing demand for cosmetic dentistry, an increase in patients' willingness to pay for dental treatment, and growing numbers of older dentate patients have all put pressure on dental systems. Ways of meeting these challenges and ensuring reasonable dental access will vary from country to country, but the solutions often lie in how the dental workforce is regulated. This case study of the dental reforms currently being implemented in England highlights progress at a particular point in time (Summer 2005). It is clear that it will take a number of years to find a new national dental payment system (the National Health Service) to replace the system which has changed little since 1948. However, the political pressure to address poor access to state-funded dental services calls for more immediate actions. The initial approach was to increase the dental workforce via international recruitment, and in the medium term to increase the number of dental students in training and to expand the numbers of other members of the dental team. An additional stratagem is to retain those already providing dental care under the National Health Service by the introduction of a new method of remuneration. England is trying to improve both access to care and the oral health of the population by creating a workforce more suitable to public demands and changing oral health needs.

Dental Health Services↗
PubMed2005

Patients' experiences with partial dentures: a qualitative study.

OBJECTIVE: The aim of the study was to gain insight into people's experiences of being given and using partial dentures. METHODS: In-depth semi-structured interviews were carried out with 23 people of varied age, social background and denture wearing experience in Tayside, Scotland. Participants were encouraged to discuss how they came to have partial dentures, their day-to-day denture use and their interactions with dentists. The interview data were systematically coded using key theme headings, and summary charts were constructed to facilitate analysis. RESULTS: The initial decision that a partial denture was needed was generally difficult to accept. People perceived the main benefits of partial dentures to be improved appearance and confidence, but experienced a variety of difficulties with their dentures and often coped with these by only wearing them on social occasions. Participants had not always told their dentists about the difficulties they experienced. Barriers to seeking help with denture problems included financial constraints, previous experience of rushed appointments or poor communication from dentists and a perceived lack of entitlement to help when partial dentures were issued free. CONCLUSIONS: Partial dentures can be difficult to cope with. People experience a range of difficulties in wearing them, not all of which have been discussed with dentists. Informative and supportive communication when partial dentures are first needed, and subsequently, can improve the quality of patients' experiences and may help promote effective use and appropriate help-seeking by partial denture wearers.

Adaptation, Psychological↗
PubMed1977

Expenditures for the dental care of indigent children in the Chattanooga project, 1971-1975.

This paper is part of a continuing study of the cost of children's dental care in a publicly funded model program. The Program--the Chattanooga Project--was designed to provide information and experience necessary for the development of similar programs elsewhere in the United States. From 1970 to 1975 comprehensive dental care was provided, at no charge, to an average of 5,500 indigent children per year. Children were treated in private practices (39%), public fixed clinics (20%), and public mobile clinics (41%). Costs were defined as public expenditures for purchasing care from private practitioners or producing care in public practices. As a framework for the analysis, program activities and their respective costs were divided into direct and indirect components. The former relate to the provision of care and the latter to noncare-oriented activities. Direct (indirect) costs per patient were $46.56 ($16.31) in private practices, $40.17 ($16.11) in fixed clinics, and $35.49 ($13.41) in mobile clinics. These results substantiate previous findings from a shorter period. A priori reasons for differences among the three modes in terms of patients' health status or the type of care provided have been specified and are currently under investigation.

Adolescent↗
PubMed1996

A critical assessment of orthodontic standards in England and Wales (1990-1991) in relation to changes in prior approval.

Targeting, use of appliances, and standards of outcome for General Dental Service orthodontic cases collected between 1990 and 1991 were compared with a sample of cases from an earlier study, collected between 1987 and 1988, using the PAR index and IOTN. Comparisons are made generally and in relation to the changes in prior approval regulations for cases started since October 1987. More lower-need cases were treated, but there were no more "unnecessary' treatments and there has been a limited improvement in outcomes, as assessed by the indices, associated with increased use of fixed appliances since 1987. Prior approval appeared to give no tangible benefits in terms of levels of unnecessary treatment or quality of outcome.

England↗