The use of the BDA Case Mix Model to assess the need for referral of patients to specialist dental services

Br Dent J. 2016 Apr 22;220(8):401-6. doi: 10.1038/sj.bdj.2016.296.

Abstract

Background: Access to health services is a right for every individual. However, there is evidence that people with disabilities face barriers in accessing dental health. One of the reasons associated with this is the unclear referral pathway existing in the Irish dental health service. The appropriate assignment of patients to relevant services is an important issue to ensure better access to healthcare. This is all the more pertinent because there are only a few trained dental practitioners to provide dental treatment for people with disabilities, as well as even fewer qualified specialists in special care dentistry.

Aims: The aim of this part of the study was to assess the use of the BDA Case Mix Model to determine the need for referral of patients to specialist dental services, and to determine any association between patient complexity and the need for adjunct measures, such as sedation and general anaesthesia for the management of people with disabilities and complex needs.

Methodology: A retrospective analysis of dental records using the BDA Case Mix Model.Results The results showed that patients with different levels of complexities were being referred to the special care dentistry clinic at the Dublin Dental University Hospital. The results also showed that the need for supportive adjunct measures such as sedation and general anaesthesia was not necessarily the main reason for referring patients to specialist services. The assessment with the BDA Case Mix Model was comprehensive as it looked at many factors contributing to the cases' complexity. Not all categories in the Case Mix Model had significant association with the need for an adjunct.Conclusion The BDA Case Mix Model can be used to measure the need for supportive adjunct measures, such as sedation and general anaesthesia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Dental Care / statistics & numerical data
  • Diagnosis-Related Groups / statistics & numerical data*
  • Female
  • Health Services Accessibility / statistics & numerical data
  • Health Services Needs and Demand / statistics & numerical data
  • Humans
  • Infant
  • Ireland
  • Male
  • Middle Aged
  • Models, Statistical
  • Referral and Consultation / statistics & numerical data*
  • Societies, Dental
  • Specialties, Dental* / statistics & numerical data
  • United Kingdom
  • Young Adult