Holmes R D, Donaldson C, Exley C, Steele J G
Academic Specialist Registrar in Dental Public Health, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW.
Br Dent J. 2008 Sep 27;205(6):E11; discussion 328-9. doi: 10.1038/sj.bdj.2008.755. Epub 2008 Sep 5.
To investigate priority setting and decision-making in primary care organisations and to determine how resources are managed in order to meet the oral health needs of local populations.
This is a qualitative study. The purposive sample comprised twelve dental public health consultants and six senior finance representatives from contrasting care systems across the United Kingdom. Participants completed a written information sheet followed by a recorded semi-structured telephone interview. Conversations were professionally transcribed verbatim and analysed independently by two investigators using the constant comparative method.
The emergent themes focused upon: the role of participants in decision-making; professional relationships; managing change; information needs; and identifying and managing priorities. There was wide interpretation with respect to participants' roles and perceived information needs for decision-making and commissioning. A unifying factor was the importance placed by participants upon trust and the influence of individuals on the success of relationships forged between primary care organisations and general dental practitioners.
To facilitate decision-making in primary care organisations, commissioners and managers could engage further with practitioners and incorporate them into commissioning and resource allocation processes. Greater clarity is required regarding the role of dental public health consultants within primary care organisations and commissioning decisions.
调查基层医疗组织中的优先级设定和决策制定情况，并确定如何管理资源以满足当地人群的口腔健康需求。
这是一项定性研究。目的抽样包括来自英国不同医疗体系的12名牙科公共卫生顾问和6名高级财务代表。参与者先填写一份书面信息表，随后进行一次有记录的半结构化电话访谈。对话由专业人员逐字转录，两名研究人员使用持续比较法独立进行分析。
浮现出的主题集中在：参与者在决策中的作用；专业关系；管理变革；信息需求；以及确定和管理优先级。对于参与者在决策和委托方面的角色以及感知到的信息需求存在广泛的解读。一个统一的因素是参与者对信任的重视以及个人对基层医疗组织与普通牙科医生之间建立的关系成功与否的影响。
为便于基层医疗组织进行决策，委托方和管理者可进一步与从业者互动，并将他们纳入委托和资源分配流程。基层医疗组织中牙科公共卫生顾问的角色以及委托决策需要更加明确。
