Nordic Healthcare Group, Helsinki, Finland.
Insitute of Dentistry, University of Eastern Finland, Kuopio, Finland; Social and Health Services, City of Espoo, Finland.
Int Dent J. 2023 Oct;73(5):685-691. doi: 10.1016/j.identj.2022.12.008. Epub 2023 Jan 23.
Outcomes of oral health care must be measured and analysed to improve oral health care delivery, outcomes, and quality. This study aims to develop and test outcome measures for the needs of oral health organisers and explore their feasibility using clinical data.
Based on the literature review and oral health advisory board, outcome measures for oral health care were identified, developed, and tested. Data from 425,000 clinical examinations were obtained from the clinical records of 8 public oral care providers in Finland.
The advisory board selected 7 outcome measures: 1 on oral self-care, 2 on periodontitis, 3 on caries, and 1 on missing teeth. A large variation was found in the diagnostic and data entry practices of these outcome measures. The coverage of caries and missing teeth entries was good, but the quality of initial and remineralised caries entries was questionable. The caries and missing teeth measures show statistically significant differences amongst some providers.
The measures "new cavitated caries surfaces," "cavity-free clinical examinations," and "the change in the missing value" were evaluated as feasible. The results of these measures provided insight about the effectiveness of oral care and enabled the comparison between the providers and age groups. Statistically significant differences between the providers in the measures imply potential possibilities for providers to learn from each other.
为了改善口腔保健服务的效果、质量和提升其交付水平，必须对口腔保健的结果进行衡量和分析。本研究旨在开发和检验口腔保健组织者所需的结果衡量标准，并使用临床数据来探索其可行性。
基于文献回顾和口腔健康顾问委员会，确定、制定和检验了口腔保健的结果衡量标准。从芬兰 8 家公共口腔保健机构的临床记录中获得了 42.5 万例临床检查的数据。
顾问委员会选择了 7 项结果衡量标准：1 项关于口腔自我保健，2 项关于牙周炎，3 项关于龋齿，1 项关于缺牙。这些结果衡量标准在诊断和数据录入方面存在很大差异。龋齿和缺牙条目涵盖情况良好，但初始龋齿和再矿化龋齿条目的质量值得怀疑。龋齿和缺牙衡量标准在某些提供者之间存在统计学上的显著差异。
衡量标准“新的龋坏表面”、“无龋临床检查”和“缺失值的变化”被评估为可行。这些措施的结果提供了有关口腔保健效果的信息，并能够比较提供者和年龄组之间的差异。提供者之间在这些措施上的统计学显著差异表明提供者之间可能存在相互学习的潜力。
