Cardiff University, Applied Clinical Research and Public Health, Cardiff Dental School, University Dental Hospital, Heath Park, Cardiff CF14 4XY.
Br Dent J. 2012 Feb 10;212(3):E5. doi: 10.1038/sj.bdj.2012.98.
To detail orthodontic provision in Wales.
In 2006 the new orthodontic contract was introduced in the NHS in England and Wales. Since the introduction of the new contract there have been recent reports of inefficiencies in orthodontic provision in Wales in terms of: orthodontic provision reaching those who need it, type of orthodontic activities undertaken, who is providing orthodontic care, the relative cost-efficiency of the orthodontic services, contracting and performance management of the services and robustness of the orthodontic database.
2008/09 orthodontic data on contracted services were analysed. Data from the salaried services was collected through a questionnaire. Normative orthodontic treatment need was estimated from mid-year population estimates.
In 2008/09, there were considerable inefficiencies in the orthodontic services in Wales with varied level of access by children living in 22 former local health boards, co-terminus with local authorities in Wales. Total spend on orthodontics in Wales was around £12,718,370. It was estimated that 11,539 (30%) of 12-17-year-olds required orthodontic treatment. In 2008/09, 11,031 children received orthodontic treatment in all NHS services in Wales indicating a potential shortfall of 508 treatments. Out of 135 GDS/PDS orthodontic contracts, 27 provided no active treatment (only assessments) and 62 provided less than 50 treatments annually. Cost per units of orthodontic activity (UOA) ranged from £58 to £74. With improved contracts and efficiency, the orthodontic budget seems sufficient to meet the orthodontic need of the population.
As with any type of NHS provision, it is important that orthodontic services are competitive, highly efficient and provided on the basis of need. Performance management of orthodontic services should focus on the number of successful orthodontic treatments delivered annually. The personal dental services (PDS) orthodontic contract will need to be modified accordingly.
详细介绍威尔士的正畸服务。
2006 年，新的正畸合同在英格兰和威尔士的国民保健制度中引入。自新合同引入以来，最近有报道称威尔士的正畸服务存在效率低下的情况，具体表现在：正畸服务提供给有需要的人、开展的正畸活动类型、提供正畸护理的人员、正畸服务的相对成本效益、服务的合同和绩效管理以及正畸数据库的稳健性。
分析了 2008/09 年签约服务的正畸数据。通过问卷调查收集了薪制服务的数据。从中年人口估计中估算出规范的正畸治疗需求。
2008/09 年，威尔士的正畸服务存在相当大的效率低下问题，居住在 22 个前地方卫生局辖区的儿童（与威尔士地方当局的边界相同）获得服务的程度各不相同。威尔士的正畸总支出约为 1271.837 万英镑。据估计，11.539（30%）名 12-17 岁的青少年需要正畸治疗。2008/09 年，威尔士所有国民保健服务共为 11031 名儿童提供了正畸治疗，表明潜在的治疗缺口为 508 例。在 135 个 GDS/PDS 正畸合同中，有 27 个合同未提供任何积极治疗（仅提供评估），62 个合同每年提供的治疗次数少于 50 次。单位正畸活动成本（UOA）范围为 58 英镑至 74 英镑。通过改进合同和提高效率，正畸预算似乎足以满足人群的正畸需求。
与任何类型的国民保健服务一样，正畸服务具有竞争力、高效率且基于需求提供非常重要。正畸服务的绩效管理应侧重于每年提供的成功正畸治疗数量。个人牙科服务（PDS）正畸合同将需要相应修改。
