Abstract
Dental capitation plans are a relatively recent concept. They should equitably spread the predicted monthly cost of care so as to provide financial assurance to patients and to clinicians. This cost may take into account both patients’ historic needs and current disease states, and should ideally also include an assessment of predicted clinical risks.
Plans should provide for individual, appropriately timed reviews, care and treatment based on these needs and risks, and should promote self-care by the patient as well as a preventive ethos whereby both parties—clinician and patient—are motivated to achieve optimally reduced needs and future risks of disease. By inference this will ideally reduce costs and resources, enabling the dental team to care for more patients, thus serving the interests of all.
Capitation plans should aspire to promote a dentist-patient partnership approach, with each party striving towards a longer-term objective of optimal oral health. Ongoing clinical risk assessments can support efficiency, enable effectiveness and demonstrate good outcomes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Cockcroft B. Presentation to British Society of Dental Hygienists and Therapists. 9 November 2012.
Frandsen A, editor. Preventive dentistry in practice. Oslo: Munksgaard; 1976. p. 9–16.
Pitts NB. Are we ready to move from operative to nonoperative/preventive treatment of dental caries in clinical practice? Caries Res. 2004;38:294–304.
Bauernschuster S, Driva A, Hornung E. Bismarck’s health insurance. The Global Dispatches; 2017. www.theglobaldispatches.com/articles/bismarcks-health-insurance/. Accessed 21 July 2018.
Holt VP. Dentistry as a business: in search of the moral high ground. Prim Dent Care. 2010;17(3):137–42.
Wolfart S, Quaas AC, Freitag S, Kropp P, Gerber WD, Kern M. General well-being as an important co-factor of self-assessment of dental appearance. Int J Prosthodont. 2006;19(5):449–54.
Palvarinne R, Widstrom E, Forsberg BC, Eaton KA, Birkhead D. The healthcare system and the provision of oral healthcare in European Union member states. Part 9: Sweden. Br Dent J. 2018;224(8):647–51.
Zickert I, Jonson A, Klock B, Krasse B. A capitation model to stimulate both dentists and patients to apply existing preventive knowledge. Br Dent J. 2000;189:480–6.
Bratthall D, Petersson GH. Cariogram – a multifactorial risk assessment model for a multifactorial disease. Community Dent Oral Epidemiol. 2005;33:256–64.
Anup N, Vishnani P. Cariogram – a multi-factorial risk assessment software for risk prediction of dental caries. Int J Sci Stud. 2014;1(4):58–62.
Cagetti MG, Bonta G, Lingstrom P, Strohmenger L, Campus G. Are standardized caries risk assessment models effective in assessing actual caries status and future caries increment? A systematic review. BMC Oral Health. 2018;18(1):123.
Andås CA, Hakeberg. Payment systems and oral health in Swedish dental care: Observations over six years. Community Dent Health. 2016;33:257–61.
Andas CA, Ostberg A-L, Berggren P, Hakeberg M. A new dental insurance scheme – effects on the treatment provided and costs. Swed Dent J. 2014;38:57–66.
Hakeberg M, Boman UW. Patient characteristics in relation to dental care payment model: capitation vs fee for service. Community Dent Health. 2016;33:252–6.
Petersson GH, Twetman S. Relationship between risk assessment and payment models in Swedish Public Dental Health Service: a prospective study. BMC Oral Health. 2017;17:40–5.
Rhodes SK. Dental capitation insurance provider compensation: a fair deal? Am J Manag Care. 2010;16(11):e276–80.
Boffa J, Pekruhn R. Prediction of dental care costs by use of a probability model. Public Health Rep. 1975;90(6):528–31.
Frankel M, Boffa J. Prepaid dental care technical assistance manual. Boston: Jerold Enterprises Inc.; 1974.
Schoen MH. Methodology of capitation payment to group dental practice and effects of such payment on care. Health Serv Rep. 1974;89(1):16–24.
Boffa J, Pekruhn R. Cost analysis in dentistry: as applied to operative dentistry. J Pedod. 1978;2(3):187–99.
Schoen MH. Capitation in dentistry: original concepts and current reality. J Public Health Policy. 1991;12(2):199–208.
Atchison KA, Schoen MH. A comparison of quality in a dual-choice dental plan: capitation versus fee-for-service. J Public Health Dent. 1990;50(3):186–93.
Coventry P, Holloway PJ, Lennon MA, Mellor AC. A capitation system for the treatment of children in the general dental service. Br Dent J. 1986;160(5):174–7.
White D, Anderson RJ. Children’s dental health under the capitation scheme. Community Dent Health. 1996;13(Suppl 1):21–48.
Mellor AC, Blinkhorn AS, Hassall DC, Holloway PJ, Worthington HV. An assessment of capitation in the general dental services contract 2. Patterns of treatment provided regularly attending patients. Br Dent J. 1997;182(12):460–4.
Wright K. Dentists’ pay and the National Health Service (Primary Care) Bill: pp 7-9. House of Commons research paper 97/17. https://researchbriefings.parliament.uk/ResearchBriefing/Summary/RP97-17. Accessed 16 July 2018.
House of Commons Health Committee. Dental services. Fifth report of session 2007-8. London: The Stationery Office; 2008.
Steele J. NHS dental services in England: an independent review. London: Department of Health; 2009.
NHS Dental Contract Pilots – Early Findings. Gateway reference 18199. London: Department of Health; 2012.
NHS Dental Contract Pilots. Learning after first two years of piloting. London: Department of Health; 2014.
Dental Contract Reform: Prototypes. Evaluation of the first year of prototyping 2016-2017. London: Department of Health & Social Care; 2018.
Internal communication. Simplyhealth Professionals. 2018.
Burke FJ, Wilson NH. Measuring oral health: an historical view and details of a contemporary oral health index (OHX). Int Dent J. 1995;45(6):358–70.
Burke FJT, Busby M, McHugh S, Delargy S, Mullins A, Matthews R. Evaluation of an oral health scoring system by dentists in general dental practice. Br Dent J. 2003;194:214–8.
Burke FJ, Busby M, Matthews R. Minimal data sets (comment). Br Dent J. 2001;191(9):476.
Page RC, Krall EA, Martin J, Mancl L, Garcia RI. Validity and accuracy of a risk calculator in predicting periodontal disease. J Am Dent Assoc. 2002;133(5):569–76.
Page RC, Martin J, Krall EA, Mancl L, Garcia R. Longitudinal validation of a periodontal risk calculator. J Clin Periodontol. 2003;30:819–27.
Busby M, Chapple E, Matthews R, Chapple IL. Practitioner evaluation of a novel online integrated oral health and risk assessment tool: a practice pilot. Br Dent J. 2013;215(3):115–20.
Busby M, Chapple L, Matthews R, Burke FJ, Chapple I. Continuing development of an oral health score for clinical audit. Br Dent J. 2014;216(9):526–7.
Sharma P, Busby M, Chapple L, Matthews R, Chapple I. The relationship between general health and lifestyle factors and oral health outcomes. Br Dent J. 2016;221(1):65–9.
Sharma P, Yonel Z, Busby M, Chapple IL. Association between periodontal health status and patient-reported outcomes in patients managed in a non-specialist, general dental practice. J Clin Periodontol. 2018;45:1440–7.
Busby M, Martin J, Matthews R, Burke FJ, Chapple I. The relationship between oral health risk and disease status and age and the significance for general dental practice funding by capitation. Br Dent J. 2014;217(10):576–7.
Busby M, Fayle S, Chapple L, Clover H, Chapple I. Practitioner evaluation of an online oral health and risk assessment tool for young patients. Br Dent J. 2017;223(8):595–9.
Lang NP, Suvan JE, Tonetti MS. Risk factor assessment tools for the prevention of periodontitis progression: a systematic review. J Clin Periodontol. 2015;42(suppl 16):S59–70.
McDonald R, Cheraghi-Sohi S, Tickle M, Doran T. The impact of incentives on the behaviour and performance of primary care professionals. A report for the National Institute for Health Research Service Delivery and Organisation programme. London: HMSO; 2010.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Matthews, R. (2020). Risk Driven Capitation Models. In: Chapple, I., Papapanou, P. (eds) Risk Assessment in Oral Health. Springer, Cham. https://doi.org/10.1007/978-3-030-38647-4_12
Download citation
DOI: https://doi.org/10.1007/978-3-030-38647-4_12
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-38646-7
Online ISBN: 978-3-030-38647-4
eBook Packages: MedicineMedicine (R0)