Special Issue "Efficiency and Quality in Dental Medicine"

A special issue of Dentistry Journal (ISSN 2304-6767).

Deadline for manuscript submissions: 30 August 2019.

Special Issue Editor

Guest Editor
Dr. Romesh Nalliah

University of Michigan School of Dentistry, Ann Arbor, United States
Website | E-Mail
Interests: evaluations of healthcare processes; hospital processes and educational processes

Special Issue Information

Dear colleagues,

Quality of care and efficiency of care are two matters that have not received a great deal of attention in dental medicine. Private practitioners are incentivized to deliver efficient and high-quality care to maximize profits and bring return customers. However, all dentists know that less than adequate work can still last a long time. Imperfect margins, inadequate esthetics, overhangs, and under-fills can last many years in some patients. There is no true reward for high-quality or highly-efficient care in dental medicine.

The predominant reimbursement model in the dental profession is fee-for-service, which rewards only volume. Moreover, prevention is not reimbursed as much as intervention and research has demonstrated that fee-for-service models subconsciously (or consciously) incentivize us to treat aggressively rather than conservatively [1]. In fact, even the World Health Organization reports that fee-for-service results in “overservicing” because neither doctor nor patient have any incentive to reduce costs [2].

As a result of this, our profession may give less regard to efficiency and quality than peers in medicine, for whom income is affected by these outcomes. My vision for this Special Issue is to publish articles that demonstrate measureable improvements in efficiency and/or quality of patient care that can be adapted by other practices and clinics in the dental profession. Although there is currently no direct financial incentive for high-quality or highly-efficient care, this is a goal our profession must unrelentingly pursue. As more research demonstrates that oral health is linked to systemic health [3], it is critical to the health of our patients that we deliver excellent dental care.

We would like to invite you to consider submitting articles to this Special Issue of TDJ entitled, “Efficiency and Quality in Dental Medicine.” Articles published are publicly available to the dental community and TDJ is indexed in PubMed, with full-text archiving in PubMed Central and high visibility (ISSN 2304-6767, https://www.mdpi.com/journal/dentistry).

References

  1. Nguyen L.L., Smith A.D., Scully R.E., Jiang W., Learn P.A., Lipsitz S.R., Weissman J.S., Helmchen L.A., Koehlmoos T., Hoburg A., Kimsey L.G.. Provider-Induced Demand in the Treatment of Carotid Artery Stenosis: Variation in Treatment Decisions Between Private Sector Fee-for-Service vs Salary-Based Military Physicians. JAMA Surg. 2017, 152, 565-572. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831423/
  2. World Health Organization (WHO). Health System Financing. WHO: Geneva, Switzerland; 2010. p. 72–5. http://apps.who.int/iris/bitstream/handle/10665/44371/9789241564021_eng.pdf;jsessionid=24107EA385266474B5057415497B4893?sequence=1
  3. Jeffcoat M.K., Jeffcoat R.L., Gladowski P.A., Bramson J.B., Blum J.J. Impact of Periodontal Therapy on General Health: Evidence from Insurance Data for Five Systemic Conditions. Am J Prev Med. 2014, 47, 166–174. (https://www.sciencedirect.com/science/article/pii/S0749379714001536?via=ihub)

Dr. Romesh Nalliah
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Dentistry Journal is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Efficiency
  • Health Economics
  • Patient Safety
  • Prevention
  • Public Health
  • Quality
  • Quality Assurance
  • Quality Improvement

Published Papers (3 papers)

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Research

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Open AccessArticle
Improving Efficiency in Dental School Clinics by Computerizing a Manual Task
Dent. J. 2019, 7(2), 44; https://doi.org/10.3390/dj7020044
Received: 6 February 2019 / Revised: 10 April 2019 / Accepted: 13 April 2019 / Published: 1 May 2019
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Abstract
Background: We computerized a formerly manual task of requesting dental faculty to conduct quality checks on student providers during patient encounters. We surveyed student providers who experienced the manual and computerized versions of the faculty request process for one year each. Methods: All [...] Read more.
Background: We computerized a formerly manual task of requesting dental faculty to conduct quality checks on student providers during patient encounters. We surveyed student providers who experienced the manual and computerized versions of the faculty request process for one year each. Methods: All surveys were emailed to student providers and there were no reminders or incentives to complete the survey. Simple descriptive data were used to present the results of the study and Institutional Review Board (IRB) approval was provided by the University of Michigan Medical School Committee on Human Research (HUM00131029) on 1 June 2018 Results: The response rate for the survey was 47.1%. A total of 16.1% of student providers reported that the Faculty Request System (FRS) helped them save 1–10 min per clinic session, 22.3% said it saved them 11–20 min, 29.5% said it saved them 21–30 min, 21.4% said it saved 31–40 min, 2.67% said it saved 41–50 min, and 7.14% said it saved more than 50 min per clinic session. Regarding how student providers used the additional time they gained from the FRS, 96.4% said they used some of the time to write up their notes, 88.4% said they used some of the time to discuss treatments with their patients, 83.9% said they engaged in general conversation with their patients, 81.3% said they took care of other patient-related duties, while 1.8% said they had less time available after the implementation of the FRS. Conclusions: The FRS enabled student providers to remain with their patients for almost a full 30 min more (during a 3 h session). This paper describes several benefits experienced by student providers, and the resulting impacts on patient experiences. Full article
(This article belongs to the Special Issue Efficiency and Quality in Dental Medicine)
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Open AccessArticle
Characteristics of Patients Discontinuing Care
Dent. J. 2019, 7(2), 31; https://doi.org/10.3390/dj7020031
Received: 10 January 2019 / Revised: 28 February 2019 / Accepted: 15 March 2019 / Published: 28 March 2019
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Abstract
Objectives: Due to lower fees, dental school clinics (DSCs) may provide dental care for vulnerable populations. This study evaluates factors associated with patients deciding to discontinue care at a DSC. Methods: This is a retrospective analysis of a patient transfer form that was [...] Read more.
Objectives: Due to lower fees, dental school clinics (DSCs) may provide dental care for vulnerable populations. This study evaluates factors associated with patients deciding to discontinue care at a DSC. Methods: This is a retrospective analysis of a patient transfer form that was implemented to smooth transition of a patient when their student provider graduated. Forms provided deidentified information about characteristics and unmet dental needs. Descriptive and bivariate statistics were used to identify associations between patient characteristics and deciding to continue treatment in the student practice. Results: Of 1894 patients, 73.4% continued care. Financial limitations were most commonly reported as the reason for discontinuing care (30.1%). Patients speaking a language other than English or who had reported financial barriers were significantly less likely to continue care. Conclusions: Dental school patients from vulnerable groups are more likely to discontinue care. Dental schools should implement programs that will assist patients in maintaining a dental home. Full article
(This article belongs to the Special Issue Efficiency and Quality in Dental Medicine)
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Other

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Open AccessCommentary
Reaching Vulnerable Populations through Portable and Mobile Dentistry—Current and Future Opportunities
Dent. J. 2019, 7(3), 75; https://doi.org/10.3390/dj7030075
Received: 16 May 2019 / Revised: 2 July 2019 / Accepted: 8 July 2019 / Published: 1 August 2019
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Abstract
The Action for Dental Health Act of 2017 bill is intended to prevent dental disease and divert dental emergencies from high-cost centers (like hospital emergency rooms) to dental offices. Lines 15–17 of the bill include grant funding to support portable or mobile dental [...] Read more.
The Action for Dental Health Act of 2017 bill is intended to prevent dental disease and divert dental emergencies from high-cost centers (like hospital emergency rooms) to dental offices. Lines 15–17 of the bill include grant funding to support portable or mobile dental equipment, and this should lead to an expansion of opportunities to deliver and receive care through the use of portable dental equipment and mobile dental vans, i.e., portable and mobile dentistry (PMD). Historically, PMD has been valuable to bridge the access gap for those for whom transport can be a challenge, like children and the elderly. However, PMD could be valuable to large employers, allowing the employees to receive dental care with minimal disruption to their workday. Oral pain is known to affect work and school attendance, and improving access to dental care could benefit individuals, families, organizations, and communities. Full article
(This article belongs to the Special Issue Efficiency and Quality in Dental Medicine)
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