Alfa Yansane1, Stefan Listl2,3, Dyutee Dawda1, Ryan Brandon4, Joel White1, Heiko Spallek5, Muhammad F Walji6, Elsbeth Kalenderian1,7. 1. Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, CA, USA. 2. Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University - Radboudumc (RIHS), Nijmegen, The Netherlands. 3. Medical Faculty, Department of Conservative Dentistry, Section for Translational Health Economics, Heidelberg University, Heidelberg, Germany. 4. Independent Consultant, Vancouver, BC, Canada. 5. University of Sydney, School of Dentistry, Sydney, Australia. 6. Department of Diagnostic and Biomedical Sciences, University of Texas Health Science Center School of Dentistry at Houston, Houston, TX, USA. 7. Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA.
Abstract
OBJECTIVES: Despite a significant national investment in oral health, there is little understanding of the return in terms of quality. Value-based payments aim to refocus provider reimbursement based on the value created to the patient. Our objectives were to apply a set of dental quality measures to help determine the value of preventive dental care provided to children at two academic dental school clinics. METHODS: We queried the institutional electronic health records (EHRs) for patients between the ages of 6-14 years with sealable first or second permanent molars, determined caries risk status, identified if dental sealants were placed, and finally if the teeth showed evidence of new caries experience. In order to determine the cost-effectiveness of EHR-based triage of applying dental sealants, we calculated the incremental cost-effectiveness ratio (ICER) for the dental quality measures supported sealing program. RESULTS: Between the two academic sites, there were 6,155 unique children for a total of 12,302 eligible teeth without a sealant and 32,811 eligible teeth with a sealant. Teeth without a sealant were more likely to have decay (4.8 percent) than those with a sealant (1.7 percent). At both sites, patients with high caries risk were more likely to benefit from sealants compared to those patients with low risk. CONCLUSION: Implementation of caries risk stratified fissure sealant quality measures demonstrates the potential for extracting better value in oral health care.
OBJECTIVES: Despite a significant national investment in oral health, there is little understanding of the return in terms of quality. Value-based payments aim to refocus provider reimbursement based on the value created to the patient. Our objectives were to apply a set of dental quality measures to help determine the value of preventive dental care provided to children at two academic dental school clinics. METHODS: We queried the institutional electronic health records (EHRs) for patients between the ages of 6-14 years with sealable first or second permanent molars, determined caries risk status, identified if dental sealants were placed, and finally if the teeth showed evidence of new caries experience. In order to determine the cost-effectiveness of EHR-based triage of applying dental sealants, we calculated the incremental cost-effectiveness ratio (ICER) for the dental quality measures supported sealing program. RESULTS: Between the two academic sites, there were 6,155 unique children for a total of 12,302 eligible teeth without a sealant and 32,811 eligible teeth with a sealant. Teeth without a sealant were more likely to have decay (4.8 percent) than those with a sealant (1.7 percent). At both sites, patients with high caries risk were more likely to benefit from sealants compared to those patients with low risk. CONCLUSION: Implementation of caries risk stratified fissure sealant quality measures demonstrates the potential for extracting better value in oral health care.
Authors: Paul C Stark; Elsbeth Kalenderian; Joel M White; Muhammad F Walji; Denice C L Stewart; Nicole Kimmes; Thomas R Meng; George P Willis; Ted DeVries; Robert J Chapman Journal: J Dent Educ Date: 2010-10 Impact factor: 2.264
Authors: Shwetha V Kumar; Alfa Yansane; Ana Neumann; Todd R Johnson; Gregory W Olson; Suhasini Bangar; Krishna Kumar Kookal; Aram Kim; Enihomo Obadan-Udoh; Elizabeth Mertz; Kristen Simmons; Joanna Mullins; Joel M White; Elsbeth Kalenderian; Muhammad F Walji Journal: J Am Dent Assoc Date: 2020-10 Impact factor: 3.634
Authors: Suhasini Bangar; Ana Neumann; Joel M White; Alfa Yansane; Todd R Johnson; Gregory W Olson; Shwetha V Kumar; Krishna K Kookal; Aram Kim; Enihomo Obadan-Udoh; Elizabeth Mertz; Kristen Simmons; Joanna Mullins; Ryan Brandon; Muhammad F Walji; Elsbeth Kalenderian Journal: Appl Clin Inform Date: 2022-01-19 Impact factor: 2.342
Authors: Muhammad F Walji; Heiko Spallek; Krishna Kumar Kookal; Jane Barrow; Britta Magnuson; Tamanna Tiwari; Udochukwu Oyoyo; Michael Brandt; Brian J Howe; Gary C Anderson; Joel M White; Elsbeth Kalenderian Journal: J Am Med Inform Assoc Date: 2022-03-15 Impact factor: 4.497