Baâdoudi F, Trescher A, Duijster D, Maskrey N, Gabel F, van der Heijden G J M G, Listl S
1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, Vrije Universiteit University, and University of Amsterdam, Amsterdam, the Netherlands.
2 Department of Conservative Dentistry, Translational Health Economics Group, Heidelberg University, Heidelberg, Germany.
J Dent Res. 2017 Jul 1;96(8):881-887. doi: 10.1177/0022034517702331. Epub 2017 Apr 1.
Increasingly more responsive and accountable health care systems are demanded, which is characterized by transparency and explicit demonstration of competence by health care providers and the systems in which they work. This study aimed to establish measures of oral health for transparent and explicit reporting of routine data to facilitate more patient-centered and prevention-oriented oral health care. To accomplish this, an intermediate objective was to develop a comprehensive list of topics that a range of stakeholders would perceive as valid, important, and relevant for describing oral health and oral health care. A 4-stage approach was used to develop the list of topics: 1) scoping of literature and its appraisal, 2) a meeting of experts, 3) a 2-stage Delphi process (online), and 4) a World Café discussion. The aim was to create consensus through structured conversations via a range of stakeholders (general dental practitioners, patients, insurers, and policy makers) from the Netherlands, Germany, the United Kingdom, Ireland, Hungary, and Denmark. The study was part of the ADVOCATE project, and it resulted in a list of 48 topics grouped into 6 clusters: 1) access to dental care, 2) symptoms and diagnosis, 3) health behaviors, 4) oral treatments, 5) oral prevention, and 6) patient perception. All topics can be measured, as they all have a data source with defined numerators and denominators. This study is the first to establish a comprehensive and multiple-stakeholder consented topic list designed for guiding the implementation of transparent and explicit measurement of routine data of oral health and oral health care. Successful measurement within oral health care systems is essential to facilitate learning from variation in practice and outcomes within and among systems, and it potentiates improvement toward more patient-centered and prevention-oriented oral health care.
人们对医疗保健系统的响应能力和问责制的要求越来越高，其特点是医疗保健提供者及其工作的系统具备透明度并能明确展示能力。本研究旨在建立口腔健康指标，以便透明、明确地报告常规数据，从而促进更以患者为中心、以预防为导向的口腔保健。为实现这一目标，一个中间目标是制定一份全面的主题清单，一系列利益相关者会认为这些主题对于描述口腔健康和口腔保健是有效、重要且相关的。采用了四阶段方法来制定主题清单：1）文献检索与评估，2）专家会议，3）两阶段德尔菲法（在线），4）世界咖啡屋讨论。目的是通过来自荷兰、德国、英国、爱尔兰、匈牙利和丹麦的一系列利益相关者（普通牙科医生、患者、保险公司和政策制定者）进行结构化对话达成共识。该研究是ADVOCATE项目的一部分，最终形成了一份包含48个主题的清单，分为6个类别：1）获得牙科护理，2）症状与诊断，3）健康行为，4）口腔治疗，5）口腔预防，6）患者认知。所有主题均可测量，因为它们都有定义了分子和分母的数据源。本研究首次建立了一个全面且经多方利益相关者认可的主题清单，旨在指导透明、明确地测量口腔健康和口腔保健常规数据的实施。在口腔保健系统内成功进行测量对于促进从系统内部及系统之间实践和结果的差异中学习至关重要，并且有助于朝着更以患者为中心、以预防为导向的口腔保健方向改进。
