Integrating oral care in community- oriented primary care to reduce the health gap at a local level.

Abstract

Introduction: In Flemish community health centres, we consider oral health as an important aspect of integrated and integral primary care. Meanwhile we see the health gap in terms of oral care increasing among the vulnerable population.
 This workshop provides an overview of interventions, currently running in Ghent, Leuven and Brussels to close this gap. We focus on projects that improve – bottom- up - the accessibility and the organization of oral care in order to prevent large groups of citizens from falling outside the nationally regulated framework. New healthcare professions are being introduced. 
 In doing so, we run into a number of difficulties in terms of upscaling good practices, changing the financing system, sustainable cooperation with dentists, with partners and certain target groups. Join this workshop to discuss which measures downstream, midstream and upstream are needed to eliminate inequalities in oral health.
 Background: With regard to oral health, we know that a lack of preventive care and follow-up ultimately leads to more complex problems and rising costs for the patient and the community. The importance of health literacy, (preventive) oral care and adequate oral hygiene for people's general health and quality of life is generally known and has been sufficiently scientifically substantiated. (Mazevet M., 2020) Nevertheless, oral diseases such as caries remain a problem for many population groups throughout Europe, especially the socio-economically vulnerable groups continue to be hit hard. (WHO, 2022) . Belgium is no exception to this, despite the government initiatives, it appears that socially vulnerable target groups find it more difficult to find their way to professional dental care. The challenges in Belgium are great: there is not only the capacity problem among dentists, both dentists and patients experience mutual barriers. In addition, the Belgian system of payment for performance is very complex and not transparent. After all, it consists of various aspects that complicate the financial accessibility of care for many patients. (Bouckaert N., et.al., 2020). That is why several Flemish CHC's invest in oral care and try to reduce the health gap with various interventions and experiment on a mixed financing system, often with support from the local government.
 Aims: We want to inspire participants to introduce new health professionals in (preventive) oral care, and new ways of financing. This workshop will provide attendees with insight into how this approach was chosen, lessons learned and outcomes.
 
 Target: This workshop is open to everyone with interest in oral health and in change strategies at a local level, that seek impact at the macro- level of health care systems.
 Format :
 
 Introduction (5’)
 Presentation of different case studies (30')
 Interactive discussion (45’) & summary of key learnings (10’)
 
 Key Learnings: Oral care is an important aspect of primary healthcare:
 - the importance of deploying dental hygienists also for health promotion and prevention in the neighborhood
 - the possible added value of a mixed financing model
 - local change strategies with an impact on supra-local health policy