Crall J J
Department of Pediatric Dentistry, University of Connecticut Health Center, Farmington 06032-9984.
J Dent Educ. 1989 Nov;53(11):673-6.
Although technical competency continues to be viewed as an essential prerequisite for practicing dentistry, it is no longer felt to be a sufficient indicator of the effectiveness or quality of care that will be or is provided by a practitioner. Consistent with a broader definition of quality that includes timeliness and appropriateness of treatment, continuity of care, emphasis on prevention, and adequate documentation of services provided, initiatives are being mounted to develop improved methods for evaluating the effectiveness of treatment approaches and quality of care provided for patients. Fundamental to these evaluations are hypotheses relating aspects of the structure, process, and outcome dimensions of dental practice. Evidence for interrelationships among elements of these dimensions generally is weak or lacking entirely. If dentistry is to keep apace with other segments of the health care community, efficient methods must be developed to collect valid and reliable data from practice settings that will facilitate the evaluation of the impact of treatments, providers, and organizational arrangements on the oral health status and general welfare of patients.
尽管技术能力仍然被视为从事牙科工作的一项基本先决条件，但它已不再被认为是衡量从业者所提供或将提供的护理效果或质量的充分指标。与包括治疗的及时性和适当性、护理的连续性、对预防的重视以及所提供服务的充分记录在内的更广泛的质量定义相一致，正在开展各项举措，以开发改进的方法来评估治疗方法的有效性和为患者提供的护理质量。这些评估的基础是与牙科实践的结构、过程和结果维度相关的假设。这些维度要素之间相互关系的证据通常很薄弱或完全缺乏。如果牙科要跟上医疗保健领域的其他部门，就必须开发有效的方法，从实践环境中收集有效和可靠的数据，这将有助于评估治疗、提供者和组织安排对患者口腔健康状况和总体福祉的影响。
