Strategies For OH Flashcards
Information needed for planning
Socio-demographic population profile (age, ethnicity, deprivation, mobility) Disease levels (epidemiological data, disease distribution, trends) Public Concerns (population priorities, views of services, demands) Existing service provision (availability, range treatment/prevention, costs, location, access, effectiveness)
Principles of strategy design
Aim - what is to be achieved?
Objectives - what steps needed to achieve aim?
Data collection - identify problem, understand problem, possible solutions, evaluation and feedback.
Why do you need to plan a strategy?
Enables priorities to be set
Maximises results within limited resources
Guide choices - to reach desired outcome
Proactive not reactive decisions
Rational planning cycle
Assessment of need Options Decision of policy Available resources Implementations Evaluation
Need?
When an individual has an illness or disability for which there is an effective and acceptable treatment or cure.
Components of need
Not finite
Relative - wealth of population
Dynamic - new technologies, drugs, info
Subjective - professional judgement varies
Why do needs assessment?
Inverse care law
Inequalities
Changing demographics
Limited resources
Competing priorities
Advances in medical care
Health care inflation
Consumerism and accountability.
Evaluation and feedback?
Built into project, not just at end. Ask - does it work - acceptable to people - reaching people it's intended for -how are resources being used
After 1st evaluation
Reassess problem, when it is time to stop.
Why do we have OH strategies?
Improve oral health
And
Ensure access to high quality NHS dentistry
Specific Approaches
While population- aim to decrease average risk level
High risk - identify people at high risk through a screening program and offer treatment and prevention
Targeted population - identify community at high risk and treat as whole population strategy
Whole population approach
Try to decrease everyone’s exposure to agents responsible for disease
Small increase in risk for whole population gives more cases than big increase in a few individuals
Risk factors affect all of society
Whole population advantages and disadvantages
Adv
Tackled underlying health determinants
Avoids victim blaming
Enables healthy choices
Benefits whole of society
Disadvantages
Long timescale Powerful vested interests Need mobilising action - gain support and form alliances Adverse effects Issues of individuals free choice
Prevention paradox
Majority of cases come from low risk group of population and only a minority from high risk
This is because number at high risk is small
For one person to benefit many have to change behaviour and may not see benefit and could see harm
High risk strategy and A/D
Reduce risk for individuals with risk higher than general population
A
Regularly accommodated within ethos and organisation of dental care
Intervention appropriate to individual
Cost effective
D
Medicalises prevention
Non selected at low risk not no risk
Contribution to overall control of disease is small
Poor ability to predict future of individuals
Targeted population startegy
Whole population strategy adapted for local communities
Identify high risk population - variety of interventions can be used
Not all at risk included in selected group, not everyone in target group at increased risk
Emphasis on reducing inequality
