Abstract
BackgroundStructured quality management is an important aspect for improving patient dental care outcomes, but reliable evidence to validate effects is lacking. We aimed to examine the effectiveness of a quality management program in primary dental care settings in Germany.MethodsThis was an exploratory study with a before-after-design. 45 dental care practices that had completed the European Practice Assessment (EPA) accreditation scheme twice (intervention group) were selected for the study. The mean interval between the before and after assessment was 36 months. The comparison group comprised of 56 dental practices that had undergone their first assessment simultaneously with follow-up assessment in the intervention group. Aggregated scores for five EPA domains: ‘infrastructure’, ‘information’, ‘finance’, ‘quality and safety’ and ‘people’ were calculated.ResultsIn the intervention group, small non-significant improvements were found in the EPA domains. At follow-up, the intervention group had higher scores on EPA domains as compared with the comparison group (range of differences was 4.2 to 10.8 across domains). These differences were all significant in regression analyses, which controlled for relevant dental practice characteristics.ConclusionsDental care practices that implemented a quality management program had better organizational quality in contrast to a comparison group. This may reflect both improvements in the intervention group and a selection effect of dental practices volunteering for the first round of EPA practice assessment.
Highlights
Structured quality management is an important aspect for improving patient dental care outcomes, but reliable evidence to validate effects is lacking
European practice assessment In 2004, the European Practice Assessment was developed for general medical care and already in 2005, the content as well the process was adapted for general dental care settings [17,19,20]
A continuous quality improvement is an essential part of quality management programs for health care services, which includes general medical practices and dental care practices in the primary sector [18]
Summary
Structured quality management is an important aspect for improving patient dental care outcomes, but reliable evidence to validate effects is lacking. We aimed to examine the effectiveness of a quality management program in primary dental care settings in Germany. Improving the quality of healthcare is a high priority in Western health care systems [1] driven by factors such as reducing adverse events, optimizing efficiency, and enhancing patient satisfaction [2]. Quality of care can been defined and evaluated in terms of structure, process and outcomes [4]. Little is known about how to improve quality of organizational aspects of primary sector dental care. The majority of literature and the evidence base for defining and measuring quality in primary care
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