Extrait

Background and study aims The clinical activity of many high-street dentists appears to be influenced by how they are paid. If dentists are paid for each item of treatment that they provide for patients (known as fee-for-service or FFS) e.g. fillings or dentures, there is a tendency to over-treat and do more fillings and dentures. However, if dentists are paid a set amount of money per month for each patient (known as capitation), there is a tendency to under-treat or see patients less frequently. This problem of dentists responding to the incentives within a payment system is evident in the National Health Service (NHS) across the United Kingdom. In Northern Ireland, high-street dentists working in the NHS have traditionally been paid on a FFS basis, but in 2015 the Government decided to undertake a large study that paid dentists on a capitation basis. The studies will run for a year and then change back to a FFS system of payment. This presents a unique opportunity to undertake a rigorous evaluation and provide evidence on the impact of changing payment systems in NHS dentistry. The aim of this study is to evaluate the impact of a change in payment systems on the productivity of the dental team, the quality of the care provided and the patients’ experience. Who can participate? NHS dental practices in Northern Ireland. What does the study involve? The research team measure changes in clinical activity as dental practices move from being paid for what they do (FFS), to a capitation system and then back again to FFS. Participating practices and a group of practices that are not taking part are compared. In addition, the research team interviews patients and distributes questionnaires to pilot and non-pilot practices to assess dentists’ and patients’ views about these changes and how they affect the quality of care delivered. What are the possible benefits and risks of participating? The study will help inform policy makers across Europe who are grappling with the problems involved in re-designing dental services. It will also contribute valuable information to the health and social care system more broadly. No risk of participation in the study is envisaged. Where is the study run from? NHS dental practices in Northern Ireland. When is the study starting and how long is it expected to run for? July 2015 to May 2018. Who is funding the study? National Institute for Health Research (UK). Who is the main contact? Prof. Paul Brocklehurst

Critère d'inclusion

• Provision of general dental services

Liens

• isrctn
• ictrp