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The hospital‐sponsored ambulatory dental services program, part II: an evaluation of dental services
Author(s) -
SCHOEN MAX H.,
MARCUS MARVIN,
KOCH ALMA L.
Publication year - 1988
Publication title -
special care in dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.328
H-Index - 41
eISSN - 1754-4505
pISSN - 0275-1879
DOI - 10.1111/j.1754-4505.1988.tb00674.x
Subject(s) - medicine , crown (dentistry) , dental care , ambulatory , private practice , family medicine , ambulatory care , patient satisfaction , baseline (sea) , dentistry , nursing , health care , economics , economic growth , oceanography , geology
This paper examines the appropriateness and continuity of dental care rendered by the 25 hospital facilities participating in the Hospital‐Sponsored Ambulatory Dental Services Program, a $10 million effort established by the Robert Wood Johnson Foundation from 1979 to 1983. Record review data on 5,200 patients in 13 of the hospitals show that a substantially greater number of patients entered as episodic users of the system in the final phase of the evaluation than in the baseline visit; fewer of these episodic patients made the transition to initial care in the final phase. A followup study on baseline patients indicates that only 28% of the sample had a visit after the year of first contact. The trend toward episodic care is reflected in a reduced amount of preventive and operative services from baseline to final assessments. Compared with a study of private practices in California, the emphasis on surgery in the hospitals is dramatic: a dental patient accessing a hospital clinic will lose approximately one tooth as compared with a half tooth in private practice. Private practices also perform more crown and fixed partial denture services and more services across‐the‐board than the hospital clinics. Telephone interviews show that overall patient satisfaction with the hospital dental services remained high during the study (87% to 89%). Fewer patients in the final sample, however, planned to return to the hospital for all or part of their care. These findings reveal that continuity of care is a problem for hospital dental clinics. The preponderance of episodic care raises questions as to the breadth of experience offered by these hospitals to general practice residents.