Developing value-based outcome measures for oral healthcare
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School of Business |
Master's thesis
Authors
Date
2019
Department
Major/Subject
Mcode
Degree programme
Information and Service Management (ISM)
Language
en
Pages
125
Series
Abstract
Recent focus in healthcare has been on developing value-based treatment models where the central goal is to produce meaningful health outcomes for patients. The inability of the current restorative treatment model to facilitate oral health improvement has been widely recognized and there is increasing demand to make part of the compensation of dental practitioners’ dependent on achieving oral health outcomes. However, value-based compensation models are currently absent and limited literature exists on value-based oral healthcare. The development of quality measures for oral healthcare has fallen behind of other areas of healthcare and is one of the main barriers hindering oral health improvement. Most of the currently existing oral health quality indicators focus on processes of care rather than health outcomes. However, without corresponding outcome measures these quality indicators provides only limited information. Limited literature exists on the development of health outcome measures for oral healthcare. The aim of this thesis was to develop value-based oral health outcome measures for dental caries and periodontal diseases based on the currently available information from electronic health records. Due to the limited literature on oral health outcome measurement, academic literature was examined to determine what constitutes successful treatment outcomes for dental caries and periodontal diseases from an oral health perspective. This was defined as the preservation of natural tooth structure and sustainable self-management of oral diseases, which was then translated into oral health outcome measures. Seven oral health outcome measures were developed based on the available information and tested for face validity, feasibility of data collection and discriminative validity. The largest barrier hindering oral health outcome measurement was found to be the insufficient recording practices of dental practitioners. Only three of the seven identified outcome measures could be reliably measured due to feasible data collection. Two of the developed measures: cavitation free clinical examinations and average number of new cavitated surfaces were considered valid and relevant outcome measures for dental caries. The limited availability of key periodontal information was especially problematic. The main finding of this thesis is that currently preventive and early treatment of dental caries and periodontal diseases are underutilized and key clinical indicators for monitoring the effectiveness of these interventions are not routinely recorded. Therefore, the current treatment model is focused on treating the symptoms of manifested disease rather preserving oral health. The results suggest that significant health improvement could be achieved by reorienting service provision toward a more preventive focus.Description
Thesis advisor
Halme, MerjaVilkkumaa, Eeva
Penttinen, Esko
Keywords
oral healthcare, quality measurement, outcome measurement, indicators