Developing and testing pediatric oral healthcare quality measures

Objectives This systematic review aimed to (a) provide an overview of existing quality measures in the field of oral health care, and to (b) evaluate the scientific soundness and applicability of these quality measures. Methods A systematic search was conducted in three electronic databases MEDLINE (via PubMed), EMBASE (via OVID) and LILACS (via BIREME). The search was restricted to articles published between 2002 and 2018. Publications reporting on the development process or clinimetric properties of oral health care quality measures for outpatient oral health care in dental practices were included. The identified publications reporting on oral health care quality measures were critically appraised with the Appraisal of Indicators through Research and Evaluation 2.0 (AIRE 2.0) instrument to evaluate the soundness and applicability of the measures. Results The search strategy resulted in 2541 unique and potentially relevant articles. In total, 24 publications were included yielding 215 quality measures. The critical appraisal showed a large variation in the quality of the included publications (AIRE scores ranging from 38 to 78 out of 80 possible points). The majority of measures (n = 71) referred to treatment and preventive services. Comparably, few measures referred to the domain patient safety (n = 3). The development process of measures often exhibited a lack of involvement of patients and dental professionals. Few projects reported on the validity (n = 2) and reliability (n = 3) of the measures. Four projects piloted the measures for implementation in practice. Conclusions This systematic review provides an overview of the status quo with respect to existing quality measures in oral health care. Potential opportunities include the piloting and testing of quality measures and the establishment of suitable information systems that allow the provision of transparent routine feedback on the quality of oral health care.

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“…Herndon et al (2015a); Herndon et al (2015b); American Dental Association (2016); American Dental Association (2018); Hunt & Ohja (2017)…”

Section: Resultsmentioning

confidence: 99%

“…Looking at the overall scores, the scores ranged from 38 to 78 out of 80 possible points. The highest scoring publications stem from the last 3 years . Appendix shows an oversight of the funding bodies and possible competing interests of the reviewed publications.…”

Section: Resultsmentioning

confidence: 99%

Quality measures for dental care: A systematic review

Righolt

Sidorenkov

Faggion

et al. 2018

Comm Dent Oral Epid

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“…Participants rated each of the eight characteristics on a scale of 1 to 9, where 1 was “not essential” and 9 was “definitely essential.” The rating approach was adapted from the RAND Appropriateness Method, and similar rating scales have been used in health and dental care quality measure development . The questionnaire instructions included guidance regarding the factors to consider in rating the essentiality of each characteristic, including that participants should rate each characteristic on its own merits and not relative to other characteristics (Table ).…”

Section: Methodsmentioning

confidence: 99%

The patient‐centered dental home: A standardized definition for quality assessment, improvement, and integration

Damiano

Reynolds

Herndon³

et al. 2018

Health Services Research

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Objective To develop the first standardized definition of the patient‐centered dental home (PCDH). Data Sources/Study Setting Primary data from a 55‐member national expert panel and public comments. Study Design We used a modified Delphi process with three rounds of surveys to collect panelists’ ratings of PCDH characteristics and open‐ended comments. The process was supplemented with a 1‐month public comment period. Data Collection/Extraction Methods We calculated median ratings, analyzed consensus using the interpercentile range adjusted for symmetry, and qualitatively evaluated comments. Principal Findings Forty‐nine experts (89%) completed three rounds and identified eight essential PCDH characteristics, resulting in the following definition: “The patient‐centered dental home is a model of care that is accessible, comprehensive, continuous, coordinated, patient‐ and family‐centered, and focused on quality and safety as an integrated part of a health home for people throughout the life span.” Conclusions This PCDH definition provides the foundation for developing measures for research, care improvement, and accreditation and is aligned with the patient‐centered medical home. Consensus among a broad national expert panel—including provider, payer, and accreditation stakeholder organizations and experts in medicine, dentistry, and quality measurement—supports the definition's usability and its potential to facilitate medical‐dental primary care integration.

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“…The DQA's overall approach for measurement development and testing for the Starter Set has been described elsewhere. 12 The purpose of this article is to provide the details of measure validation for 3 evidence-based, dental care quality measures of caries prevention that were included in the Starter Set: Sealants for [6][7][8][9] Year-Old Children at Elevated Caries Risk (Sealants 6-9), Sealants for [10][11][12][13][14] Year-Old Children at Elevated Caries Risk (Sealants 10-14), and Topical Fluoride for Children at Elevated Caries Risk (Topical Fluoride). These 3 measures fall within the category of process-of-care quality measures, in which a process of care is a "health care-related activity performed for, on behalf of, or by a patient."…”

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confidence: 97%

“…10 Its initial measurement set (referred to as the Starter Set) focused on population-based quality measures of caries prevention and disease management for children that can be calculated using administrative data. 11, 12 The DQA developed the Starter Set measures using a transparent, evidence-informed, consensus-based process. Initial measure concepts were identified using a comprehensive environmental scan and expert consensus rating process regarding each potential measure's importance, feasibility, and validity.…”

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confidence: 99%