Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63100 Clermont-Ferrand, France.
Service d'Odontologie, CHU Clermont-Ferrand, 63000 Clermont Ferrand, France.
Int J Environ Res Public Health. 2023 Feb 8;20(4):2997. doi: 10.3390/ijerph20042997.
Providing dental care for certain patient groups is complicated due to difficulties with cooperation, communication, health conditions, and social context, amongst others. The majority of dentists in France work within a public fee-per-item system. A new measure has been introduced providing a financial supplement to dentists for each episode of care for a patient with a severe disability. This supplement is justified by completion of the French Case Mix tool (FCM), a new measure designed to retrospectively identify episodes of dental care that have required adaptation and additional time or expertise. The aim of this study was to investigate the validity and psychometric properties of the FCM. The content validity of the tool was improved at each round of pilot development, involving 392 patient encounters. Test-retest data at 2 weeks for 12 fictional patient treatment episodes were collected from 51 dentists. This phase confirmed inter- and intra-dentist reproducibility, criterion validity, and interpretability. Retrospective analysis of 4814 treatment episodes nationally demonstrated high reliability, internal consistency, and construct validity. Overall, the FCM showed high validity and good psychometric properties. However, the impact of providing a financial supplement on improving access to care for persons with special needs has yet to be evaluated.
为某些患者群体提供牙科护理很复杂，这是由于合作、沟通、健康状况和社会背景等方面存在困难。法国的大多数牙医都在按项收费的公共系统内工作。一项新措施为每位严重残疾患者的每一次护理提供了经济补贴给牙医。这种补贴是由完成法国病例组合工具（FCM）来证明的，该工具是一项新的措施，旨在回顾性地确定需要适应、额外时间或专业知识的牙科护理病例。本研究旨在调查 FCM 的有效性和心理测量特性。在涉及 392 例患者的三轮试点开发中，对工具的内容有效性进行了改进。从 51 名牙医中收集了 12 个虚构的患者治疗病例的 2 周测试-再测试数据。这一阶段证实了牙医间和牙医内的再现性、标准有效性和可解释性。全国范围内对 4814 个治疗病例的回顾性分析显示了高可靠性、内部一致性和结构有效性。总的来说，FCM 表现出很高的有效性和良好的心理测量特性。然而，提供经济补贴对改善特殊需求人群的护理机会的影响仍有待评估。
