Original ContributionsCaries PreventionMeasuring quality of dental care: Caries prevention services for children
Section snippets
Measure specification
On the basis of expert ratings of measure concepts identified through the environmental scan, identified gaps in measurement, and evidence regarding the effectiveness of different processes of care, the DQA identified professionally applied topical fluoride and pit-and-fissure sealants on permanent molars as primary candidates for caries prevention process-of-care measures associated with improved health outcomes (that is, to reduce dental caries and associated sequelae). The DQA developed the
Sample characteristics
Table 1 provides the member characteristics for each of the programs. Across the 5 programs, there were 6,956,669 members aged 0 to 20 years enrolled for at least 1 month. Table 2 summarizes the number of children eligible for each measure’s denominator and numerator.
Critical data element validation
Of the 600 records requested, we received 414 (69%), exceeding the targeted number of 400. The 414 records represented 631 dates of service. Table 3 summarizes the agreement between the dental records and administrative data for
Discussion
The purpose of this study was to validate 3 caries prevention, process-of-care quality measures. Our results indicate that these measures can be implemented feasibly and validly by using administrative claims data at the program and plan levels. Our testing included validation of the critical data elements used to calculate the measure scores and the overall quality measure scores. Our critical data element validation findings are similar to the results of a study whose investigators used data
Conclusions
Professionally applied topical fluoride and timely application of pit-and-fissure sealants to permanent molars are effective caries prevention services. In this study, we validated 3 evidence-based, process of care, caries prevention quality measures: Topical Fluoride for Children at Elevated Caries Risk, Sealants for 6–9 Year-Old Children at Elevated Caries Risk, and Sealants for 10–14 Year-Old Children at Elevated Caries Risk. Based on the study findings, NQF endorsed these 3 measures,17
Dr. Herndon was an associate professor, Department of Health Outcomes and Policy and Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, when this article was written. She now is a principal consultant, Key Analytics and Consulting, Gainesville, FL, and a methodology consultant, Dental Quality Alliance, Chicago, IL. She also is a courtesy research associate professor, Departments of Economics, Community Dentistry and Behavioral Science, and
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2021, Journal of the American Dental AssociationCitation Excerpt :For example, claims-level DQA quality measures can posit regular receipt of care (usually once per year for “any,” “preventive,” and “treatment”) as a quality measure. Future studies can use these quality of care measures to examine the dental care delivered, comparing differing practice settings for publicly insured children.23,36 We can also use these measures in future studies with patient-level data to examine the effect of Medicaid dental program reform across the identified dental practice settings related to cost, treatment, and DQA outcomes or quality measures of dental care.
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Dr. Herndon was an associate professor, Department of Health Outcomes and Policy and Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, when this article was written. She now is a principal consultant, Key Analytics and Consulting, Gainesville, FL, and a methodology consultant, Dental Quality Alliance, Chicago, IL. She also is a courtesy research associate professor, Departments of Economics, Community Dentistry and Behavioral Science, and Pediatrics, University of Florida, Gainesville, FL.
Dr. Tomar is a professor and chair, Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL.
Dr. Catalanotto is a professor, Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL.
Dr. Rudner is an associate director, Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL.
Dr. Huang was an associate professor, Department of Health Outcomes and Policy and Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, when this article was written. He now is an associate member, Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN.
Dr. Aravamudhan is the director, Center for Dental Benefits, Coding and Quality, and lead staff, Dental Quality Alliance, American Dental Association Practice Institute, Chicago, IL.
Dr. Shenkman is a professor and chair, Department of Health Outcomes and Policy, and director, Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL.
Dr. Crall is a professor and chair, Division of Public Health and Community Dentistry, School of Dentistry, University of California – Los Angeles, Los Angeles, CA; chair, Dental Quality Alliance Measures Development and Maintenance Committee, and 2015 chair, Dental Quality Alliance, Chicago, IL.
Disclosure. None of the authors reported any disclosures.
This study was funded by the Dental Quality Alliance and the American Dental Association Foundation.
The measures identified in this manuscript were conceptualized by the Dental Quality Alliance, which continues to serve as the steward maintaining these measures and supporting implementation.
The authors thank the following members of the Dental Quality Alliance Measures Development and Maintenance Committee who developed the measures and oversaw and provided guidance for the testing efforts: Craig W. Admundson, DDS; Robert D. Compton, DDS; Christine Farrell, RDH, BSDH, MPA; Jed J. Jacobson, DDS, MS, MPH; and DQA Executive Committee liaisons to the MDMC. The authors also recognize the outstanding programming assistance provided by Yijun Sun, Howard Xu, Sunil Chilruvi, and Deepa Ranka; record review assistance by Carla Bredehoeft and Charlie Gwin; and research assistance by Kaitlin Sovich, Deina Bossa, Ryan Brown, Alex Craen, and Tyler Wildes. The authors also gratefully acknowledge the Florida Agency for Health Care Administration, the Florida Healthy Kids Corporation, the Texas Health and Human Services Commission, and DentaQuest for providing data for measure testing.