Righolt Amy, Duijster Denise, Smits Kirsten, Oerlemans Anke, van der Wees Philip, Listl Stefan
Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University - Radboudumc (RIHS), Nijmegen, The Netherlands; Capaciteitsorgaan (Council for Medical Manpower Planning), Utrecht, The Netherlands.
Department of Oral Public Health, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands.
Int Dent J. 2025 Jun;75(3):1722-1731. doi: 10.1016/j.identj.2025.03.004. Epub 2025 Apr 1.
This study aimed to identify which barriers and facilitators exist and can be expected when measuring quality of oral health care according to different stakeholders in the Netherlands.
A total of 36 semistructured interviews were conducted with dentists, patients, universities and knowledge institutes, health insurance companies, professional dental associations, and governmental health organisations. Using qualitative content analysis, barriers and facilitators were classified according to the frameworks of Grol and Cabana.
In total 70 barrier and 53 facilitating factors were identified in the 5 domains of the frameworks. Various stakeholders found quality measurement challenging because the quality of oral health care is difficult to define with a lack of consensus on what constitutes quality of oral health care. Patients mentioned that, for them, quality of oral health care is difficult to assess. Dentists experienced a fear of being monitored and were apprehensive of the administrative burden of quality measurement. On an organisational level, the isolation of dentistry from the medical field was mentioned as a barrier. Facilitating factors were discussing quality in a trusted environment, and developing more clinical practice guidelines, which include meaningful quality measures.
This study identified barriers and facilitators for measuring quality of oral health care in the Netherlands. Findings signal the importance of achieving consensus on the definition of quality of oral health care. Further strategy discussions about how quality of oral health care can be made insightful in a way acceptable to all stakeholders are needed to make progressions in quality improvement.
本研究旨在确定在荷兰，根据不同利益相关者衡量口腔医疗质量时存在哪些障碍和促进因素，以及可能会出现哪些障碍和促进因素。
对牙医、患者、大学和知识机构、健康保险公司、专业牙科协会以及政府卫生组织进行了总共36次半结构化访谈。使用定性内容分析，根据格罗尔和卡巴纳的框架对障碍和促进因素进行分类。
在框架的5个领域中总共确定了70个障碍因素和53个促进因素。由于口腔医疗质量难以界定，且对于什么构成口腔医疗质量缺乏共识，不同利益相关者都发现质量测量具有挑战性。患者提到，对他们来说，口腔医疗质量难以评估。牙医担心受到监督，并且对质量测量的行政负担感到忧虑。在组织层面，牙科与医学领域的隔离被视为一个障碍。促进因素包括在可信赖的环境中讨论质量，以及制定更多临床实践指南，其中包括有意义的质量衡量标准。
本研究确定了荷兰在衡量口腔医疗质量方面的障碍和促进因素。研究结果表明就口腔医疗质量的定义达成共识的重要性。需要进一步进行战略讨论，探讨如何以所有利益相关者都能接受的方式使口腔医疗质量具有洞察力，以便在质量改进方面取得进展。
