Strategies for Oral Health Flashcards
What information is required to understand problems with oral health ?
Socio demographic population profile - age, ethnicity, deprivation
Disease levels - epidemiology, distribution, trends
Public concerns - priorities, views of services, demands
Existing service provision - availability, cost, location, access, range of treatment
What is the purpose of a needs assessment ?
Identify and quantify the problem in terms of wants, demands and needs
What are wants, demands and needs?
Wants - individuals subjective assessments eg white fillings
Demands - willingness to pay
Needs - professional judgement about capacity to benefit
What is the definition of a “need for medical care” ?
When an individual has an illness or disability for which there is an effective and acceptable treatment or cure
Need is …
Subjective - professional judgment varies
Dynamic - new technology, drugs, information
Relative - wealth of the population
Not finite
What is a needs assessment ?
Evidence based approach to commissioning and planning health services using objective and valid methods
What are needs assessments necessary ?
Facilitates planning and commissioning, Health care inflation, Advances in medical care, Changing demographics, Limited resources, Inverse care law, Consumerism and accountability, Competing priorities
How are oral health strategies evaluated ?
Evaluation built into project not just at the end,
Does it work, is it acceptable, correct target population, how are resources being used ?
How can strategic approaches to health improvement affect the whole population ?
Lower average level of risk
How can strategic approaches to health improvement affect high risk groups ?
Identify high risk population through screening and offer treatment or prevention
What are the advantages of whole population strategies?
Tackles underlying health determinants, Avoids victim blaming, Enables healthy choices to be made, Benefits the whole of society, Generally very effective
What are the disadvantages of whole population strategies ?
Long timescale,
Powerful vested interests,
Mobilising action - need to form alliances, lobbying and gaining support
Adverse effects,
Issues of individual free choice,
Prevention paradox - small individual risk reduction
What is meant by the term “prevention paradox” ?
For one person to benefit, many people have to change their behaviour even though they receive no benefit or even suffer from the change
This is because the majority of people are at low risk and only a minority are in the high risk group
What is the aim of a high risk strategy ?
Reduce the risk for individuals identified as being at greater risk than the general population
What are the advantages of the high risk strategy ?
Cost effective use of resources,
Intervention appropriate to individual,
Readily accommodated within ethos and organisation of medical care
What are the disadvantages of the high risk strategy ?
Medicalises prevention,
Non selected individuals at low risk not no risk,
Contribution to overall control of disease may be small,
Poor ability to predict future of individuals
What is a targeted population strategy ?
Whole population approach adapted for a local community
What is involved in a targeted population strategy ?
Identify high risk groups,
Apply intervention,
Not all people at risk will be included in target group,
Not everyone win target group is at increased risk
What is the purpose of a targeted population strategy ?
Reducing inequalities
What are the features of the common risk factor approach to strategies for oral health ?
Recognises many diseases share risk factors,
Takes direct action to common risks and underlying social determinants,
Improvements in a range of common conditions,
Partnership working
what is a strategy ?
a plan of action for obtaining a specific goal or result
why should oral health strategies be planned ?
maximises results with limited resources, proactive rather than reactive decisions, enables priorities to be set
what are the principles of health strategy design ?
aim - what is to be achieved,
objectives - what steps need to be taken to achieve aim,
data collection - identity problem, understand problem, possible solutions, evaluation and feedback
what are the stages of the rational planning cycle?
assessment of need, options, decisions policy, available resources, implementation, evaluation
why are strategies needed ?
oral diseases are preventable but very common,
understand why diseases have not been prevented,
complex array of factors,
many outside health
give an example of dental health strategy
national strategy, Choosing Better Oral Health - An Oral Health Plan for England, 2005 informed 2006 dental contract based on UDA’s
what were the key aims for choosing better oral health 2005 ?
reduce prevalence of oral disease ,
reduce oral health inequalities across all age groups in England
