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Community Dentistry And Oral Epidemiology
Article . 2017 . Peer-reviewed
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The technical efficiency of oral healthcare provision: Evaluating role substitution in National Health Service dental practices in England

Evaluating role substitution in National Health Service dental practices in England
Authors: Harry Hill; Stephen Birch; Martin Tickle; Ruth McDonald; Paul Brocklehurst;

The technical efficiency of oral healthcare provision: Evaluating role substitution in National Health Service dental practices in England

Abstract

AbstractObjectivesIn many countries increasing use is being made of dental care professionals (DCPs) to provide aspects of clinical activity previously undertaken by dentists. This study evaluates the differences in practice efficiency associated with the utilisation of DCPs in the provision of General Dental Services in the National Health Service (NHS) in England.MethodsOne hundred twenty‐one NHS practices completed a questionnaire and shared practice information held at the NHS Business Services Authority. Practice efficiency was estimated using data envelopment analysis with the robustness of the findings checked using Stochastic Frontier Model estimation.ResultsDental practices operated at an estimated mean level of technical efficiency of 64%. Variations among practices in the use of DCPs were not associated with variations in practice efficiency after controlling for other staffing levels, patient population characteristics and practice variables.ConclusionsThe current NHS dental contract limits the potential for efficiency improvements by setting annual practice activity targets that produce little incentive for role substitution. Whilst DCPs may by practising efficiently, this is not reflected in practice‐level efficiency, possibly because of dentists using the time released for other non‐NHS activity.

Keywords

Therapists, Centers, Dentists, Dentists/statistics & numerical data, Efficiency, 2739 Public Health, Dental Assistants, Efficiency, Organizational, Organizational/statistics & numerical data, State Medicine, Professional Role, Surveys and Questionnaires, Humans, Dental Assistants/statistics & numerical data, Dental Care, 360, dental auxiliaries, mid-level provider, Environmental and Occupational Health, economics, England, efficiency, 3500 Dentistry, Workforce, Efficiency, Organizational/statistics & numerical data, Dental Care/methods, State Medicine/statistics & numerical data

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Average
Average
Average
Green
bronze