Chair-side preventive interventions in the Public Dental Service in Norway

BDJ ◽  
2016 ◽  
Vol 221 (4) ◽  
pp. 179-185 ◽  
Author(s):  
E. Widström ◽  
A. Tillberg ◽  
L. I. Byrkjeflot ◽  
R. Skudutyte-Rysstad
2017 ◽  
Vol 16 (2) ◽  
pp. e112-e119 ◽  
Author(s):  
E Widström ◽  
A Tillberg ◽  
LI Byrkjeflot ◽  
L Stein ◽  
R Skudutyte-Rysstad

1992 ◽  
Vol 22 (4) ◽  
pp. 669-688 ◽  
Author(s):  
Eva Bejero ◽  
Töres Theorell

The Public Dental Service in Sweden has a system of surveillance and supervision based on time studies, piecework wages for dentists, and detailed time reporting. This control system and its development are described in this article. The focus is on the effects of the system on the staff. A representative group of Swedish dentists (n = 896) and dental nurses (n = 600) was asked to participate in a questionnaire study exploring the work environment in the Public Dental Service. The response rate was 87 percent. The dentists reported that they felt constantly supervised and evaluated. Their work tempo was related to surveillance, competition, and demands of the employer. There was no correlation between work tempo and piecework results. A high percentage of the staff mentioned weaknesses in the charging and piecework system that they thought could result in an undesirable influence on dentists' work. A majority would have preferred fixed salaries. The results are discussed in terms of gender, motivation, proletarianization, and management style.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlotte Andrén Andås ◽  
Magnus Hakeberg

Abstract Background Since 2007, patients receiving oral health care within the Public Dental Service in Sweden have had the possibility to choose between the traditional fee-for-service (FFS) payment system or the new capitation payment system, ‘Dental Care for Health’ (DCH). Payment models are believed to involve different incentive structures for patients and caregivers. In theory, different incentives may lead to differences in health-related outcomes, and the research has been inconclusive. This 12-year longitudinal prospective cohort study of patients in regular dental care analyzes oral health development and self-reported oral health in relation to the patients’ level of education in the two payment systems, and compares with the results from an earlier 6-year follow-up. Methods Information was obtained through a questionnaire and from a register from n = 5877 individuals who kept their original choice of payment model for 12 years, 1650 patients in DCH and 4227 in FFS, in the Public Dental Service in Region Västra Götaland, Sweden. The data comprised manifest caries prevalence, levels of self-reported oral health and education, and choice of dental care payment model. Analyses were performed with chi square and multivariable regression analysis. Results The findings from the 6-year follow-up were essentially maintained at the 12-year examination, showing that the pre-baseline caries prevalence is the most influential factor for less favorable oral health development in terms of the resulting caries prevalence. Educational level (≥ university) showed an increased influence on the risk of higher caries prevalence after 12 years and differed between payment models with regard to the relation to self-rated oral health. Conclusions Differences in health and health-influencing properties between payment models were sustained from 6 to 12 years. Strategies for making use of potential compensatory mechanisms within the capitation payment system to increase oral health equality should be considered.


2012 ◽  
Vol 22 (1) ◽  
Author(s):  
Marit S. Skeie ◽  
Kristin S. Klock ◽  
Ola Haugejorden

<p>KOSTRA (Kommune-Stat-Rapportering) utgjør et nasjonalt informasjonssystem som gir opplysninger om kommunal og fylkeskommunal virksomhet, også når det gjelder tannhelsetjenestens virksomhet. Hovedmålet med denne artikkelen er å evaluere nytteverdien av KOSTRA-data som de per i dag innrapporteres, det vil si om de harmonerer med moderne behandlingsfilosofi av sykdommen karies og lavere kariesprevalens, samt bidrar som redskap i det tannhelsefremmende arbeid. Som delmål vil vi kritisk vurdere hvordan kariesdata blir innrapportert til KOSTRA og der blir presentert, samt diskutere videreutvikling av denne innrapporteringen. Vi fant at nåværende KOSTRA-rutiner bør endres og arbeidsmetoder oppdateres i samsvar med moderne syn på kariesforebyggelse og terapi. Det å inkludere emaljelesjoner i KOSTRArapportene og overvåke kariesutviklingen fra tidlig alder, er essensielt hvis planlegging av tannhelsetjenesten for barn og ungdom skal kunne gjennomføres på en optimal måte. Videre bør man gå over fra aggregerte data til rapportering på individnivå, eventuelt fra statistisk tilfeldige utvalg og endring av klasseinndelingen i frekvensfordelinger. Dette for å kunne estimere SIC og tilpasse fordelingene til endret karieserfaring i nøkkelårskullene. Bruk av kalibrerte undersøkere vil være en stor gevinst med tanke på å heve kvaliteten på de data som blir innrapportert, både når det gjelder reliabilitet og validitet.</p><p>Skeie MS, Klock KS, Haugejorden O. Current Norwegian routines for collection of data on caries epidemiology among children and adolescents – are the routines still adequate? Nor J Epidemiol 2012; 22 (1): 59-68.</p><p>ENGLISH SUMMARY</p><p>KOSTRA (Community-State-Report) is a national information system providing data about activity at community and country level, as well as in the Public Dental Service (PDS). The main aim of this study is to assess the usefulness of the present KOSTRA data reporting system, i.e. if it is in accordance with modern treatment philosophy of dental caries, reduced caries prevalence and if it contributes as a dental health promotion tool. As a secondary aim to critically evaluate the way caries data are reported in KOSTRA and how the data are presented as well as discuss reporting improvements. Findings show that the existing KOSTRA routines should be changed and the procedures updated in accordance with the modern philosophy of caries prevention and therapy. It is considered important to include carious lesions in enamel in the KOSTRA reports, and from an early age, to monitor caries development, for the optimal planning of the Public Dental Service for children and adolescents. Furthermore, KOSTRA should, if possible, change from an aggregated to an individual reporting level, using statistical random samples. The standard class intervals of frequency distributions should be revised to facilitate estimation of SIC in order to allow for changed caries experience in key age groups. Calibrated examiners should be used to carry out the registration in order to improve data quality in terms of reliability and validity.</p>


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