Unintended consequences and challenges of quality measurements in dentistry

Abstract Background In recent years, several state dental programs, researchers and the Dental Quality Alliance (DQA) have sought to develop baseline quality measures for dentistry as a way to improve health outcomes, reduce costs and enhance patient experiences. Some of these measures have been tes...

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Main Authors: Enihomo M. Obadan-Udoh, Jean M. Calvo, Sapna Panwar, Kristen Simmons, Joel M. White, Muhammad F. Walji, Elsbeth Kalenderian
Format: Article
Language:English
Published: BMC 2019-03-01
Series:BMC Oral Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12903-019-0726-4
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author Enihomo M. Obadan-Udoh
Jean M. Calvo
Sapna Panwar
Kristen Simmons
Joel M. White
Muhammad F. Walji
Elsbeth Kalenderian
author_facet Enihomo M. Obadan-Udoh
Jean M. Calvo
Sapna Panwar
Kristen Simmons
Joel M. White
Muhammad F. Walji
Elsbeth Kalenderian
author_sort Enihomo M. Obadan-Udoh
collection DOAJ
description Abstract Background In recent years, several state dental programs, researchers and the Dental Quality Alliance (DQA) have sought to develop baseline quality measures for dentistry as a way to improve health outcomes, reduce costs and enhance patient experiences. Some of these measures have been tested and validated for various population groups. However, there are some unintended consequences and challenges with quality measurement in dentistry as observed from our previous work on refining and transforming dental quality measures into e-measures. Main body Some examples of the unintended consequences and challenges associated with implementing dental quality measures include: a de-emphasis on patient-centeredness with process-based quality measures, an incentivization of unethical behavior due to fee-for-service reimbursement systems, the risk of compromising patient and provider autonomy with plan-level measures, a disproportionate benefits of dental quality measurement going toward payers, and the risk of alienating smaller dental offices due to the resource-intensive nature of quality measurement. Conclusion As our medical counterparts have embraced quality measurement for improved health outcomes, so too must the dental profession. Our ultimate goal is to ensure the delivery of high quality, patient-centered dental care and effective quality measurement is the first step. By continuously monitoring the performance of dental quality measures and their continued refinement when unintended consequences are observed, we can improve patient and population health outcomes.
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spelling doaj.art-0fc8cd8856894834aceb3fc9ea3ebd232022-12-22T02:38:52ZengBMCBMC Oral Health1472-68312019-03-011911510.1186/s12903-019-0726-4Unintended consequences and challenges of quality measurements in dentistryEnihomo M. Obadan-Udoh0Jean M. Calvo1Sapna Panwar2Kristen Simmons3Joel M. White4Muhammad F. Walji5Elsbeth Kalenderian6Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San FranciscoPediatric Dentistry Post-Graduate Program, School of Dentistry, University of California San FranciscoDepartment of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San FranciscoSkourtes InstituteDepartment of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San FranciscoDepartment of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science CenterDepartment of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San FranciscoAbstract Background In recent years, several state dental programs, researchers and the Dental Quality Alliance (DQA) have sought to develop baseline quality measures for dentistry as a way to improve health outcomes, reduce costs and enhance patient experiences. Some of these measures have been tested and validated for various population groups. However, there are some unintended consequences and challenges with quality measurement in dentistry as observed from our previous work on refining and transforming dental quality measures into e-measures. Main body Some examples of the unintended consequences and challenges associated with implementing dental quality measures include: a de-emphasis on patient-centeredness with process-based quality measures, an incentivization of unethical behavior due to fee-for-service reimbursement systems, the risk of compromising patient and provider autonomy with plan-level measures, a disproportionate benefits of dental quality measurement going toward payers, and the risk of alienating smaller dental offices due to the resource-intensive nature of quality measurement. Conclusion As our medical counterparts have embraced quality measurement for improved health outcomes, so too must the dental profession. Our ultimate goal is to ensure the delivery of high quality, patient-centered dental care and effective quality measurement is the first step. By continuously monitoring the performance of dental quality measures and their continued refinement when unintended consequences are observed, we can improve patient and population health outcomes.http://link.springer.com/article/10.1186/s12903-019-0726-4EthicsQualityDentistryQuality measures
spellingShingle Enihomo M. Obadan-Udoh
Jean M. Calvo
Sapna Panwar
Kristen Simmons
Joel M. White
Muhammad F. Walji
Elsbeth Kalenderian
Unintended consequences and challenges of quality measurements in dentistry
BMC Oral Health
Ethics
Quality
Dentistry
Quality measures
title Unintended consequences and challenges of quality measurements in dentistry
title_full Unintended consequences and challenges of quality measurements in dentistry
title_fullStr Unintended consequences and challenges of quality measurements in dentistry
title_full_unstemmed Unintended consequences and challenges of quality measurements in dentistry
title_short Unintended consequences and challenges of quality measurements in dentistry
title_sort unintended consequences and challenges of quality measurements in dentistry
topic Ethics
Quality
Dentistry
Quality measures
url http://link.springer.com/article/10.1186/s12903-019-0726-4
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