BDA special care case mix model

• Published in: British dental journal Vol. 208; no. 7; pp. 291 - 296
• Main Authors: Bateman, P, Arnold, C, Brown, R, Foster, L. V, Greening, S, Monaghan, N, Zoitopoulos, L
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 10-04-2010; Nature Publishing Group
• Subjects: 692/700; Adolescent; Adult; Aged; Anesthesia; Child; Child, Preschool; Children with disabilities; Communication; Community Dentistry - economics; Community Dentistry - legislation & jurisprudence; Community Dentistry - organization & administration; Contract Services - economics; Contract Services - legislation & jurisprudence; Contract Services - organization & administration; Cooperation; Cooperative Behavior; Dental care; Dental Care for Disabled - economics; Dental Care for Disabled - legislation & jurisprudence; Dental Care for Disabled - organization & administration; Dental insurance; Dentist-Patient Relations; Dentistry; Dentists; Diagnosis-Related Groups; Disability; Episode of Care; Ethics, Dental; Health care access; Health Services Accessibility - economics; Health Services Accessibility - legislation & jurisprudence; Health Services Accessibility - organization & administration; Health Status; Health Status Indicators; Humans; Infant; Learning disabilities; Medicine; Middle Aged; Needs Assessment; Oral Health; Oral hygiene; Patients; Performance management; practice; Primary care; Public health; Risk Factors; Societies, Dental; State Dentistry - economics; State Dentistry - legislation & jurisprudence; State Dentistry - organization & administration; United Kingdom; Young Adult; United Kingdom > UK; England
• ISSN: 0007-0610; 1476-5373
• DOI: 10.1038/sj.bdj.2010.294

Key Points
The model described in this article is becoming recognised and widely used in salaried dental services in UK as a useful methodology for describing the complexity of special care patients.
NHS commissioners are interested in using the model to assist in commissioning these services.
The model has potential for use in research in special care dentistry.
Routine dental care provided in special care dentistry is complicated by patient specific factors which increase the time taken and costs of treatment. The BDA have developed and conducted a field trial of a case mix tool to measure this complexity. For each episode of care the case mix tool assesses the following on a four point scale: 'ability to communicate', 'ability to cooperate', 'medical status', 'oral risk factors', 'access to oral care' and 'legal and ethical barriers to care'. The tool is reported to be easy to use and captures sufficient detail to discriminate between types of service and special care dentistry provided. It offers potential as a simple to use and clinically relevant source of performance management and commissioning data. This paper describes the model, demonstrates how it is currently being used, and considers future developments in its use.