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Community Mod 4
| Question | Answer |
|---|---|
| Dental healthcare delivery systems | Resolution of explicit oral health needs through the delivery or provision of oral health services by means of organized and sometimes interdependent activities. |
| What are the 4 levels of government that the delivery system is presented through? | International, Federal, State, and Local |
| International | Addresses concerns at an international level/population |
| Example of international organization | World Health Organization (WHO) |
| Federal | Addresses concerns at a national level/population (The entire country: USA) |
| Example of federal organization | FDA, CDC, Indian Health Services, etc. |
| State | Addresses concerns on a state level/population |
| Local | Addresses concerns on a local level/population (county/city health department) |
| Private Sector | Solo/Group dental practice |
| Solo dental practice | A single proprietor dental practice |
| Solo group dental practice | Two or more independent dentists; autonomy is maintainted |
| Group dental practice | Associates, consistent treatment; shared expense & reward |
| Hospital dental practice | Part of the hospital environment |
| Retail dental practice | Located within a retail/store environment |
| Franchise dental practice | Practicing under a trade name |
| Corporate dental practice | Company owned and operated |
| Public Sector | Federally/State/Locally Owned |
| Community health centers | Federally funded group practice |
| U.S. Public Health Services (USPHS) | Health research/promotion - Dental care for Native Americans, federal prisoners, coast guard, Hansen's disease (Leprosy) suffers |
| State and Local Programs | Programs addressing state/county/city indigent population |
| What is a concern for both public and private sectors? | Financing |
| Funding sources | Barter, Fee-for-Service, Capitation |
| Barter System | Negotiated payment via exchange of goods |
| Fee-For-Service | Traditional - payment for performance |
| Capitation | Contracted care |
| Two-party system (Payment Option) | Cash, check, charge |
| Third-party system (Payment Option) | Insurance, employer |
| Commercial insurance (Payment Option) | Operates for profit |
| Health Maintenance Organization (HMO) (Payment Option) | Managed care; control cost |
| Preferred Provider Organization (PPO) (Payment Option) | Managed care; more freedom regarding provider |
| Public Financing | The Titles... |
| Title V | Maternal & children health services block grant |
| Title XVIII Medicare | Elderly - Federal Health Insurance for 65+ |
| Title XIX Medicaid | Medicaid is not Indigent care, however it does cover some charity care |
| Title XXI | State Children's Health Insurance Program (SCHIP) |
| What dictates the mandate for financial concerns? | Demand and Utilizaiton |
| Demand | Desire of the public to receive treatment |
| Utilization | The number of individuals that use dental services; volume and type of service actually consumed |
| Need | Professional judgement as to the amount and kind of health care services required to attain/maintain health |
| Felt Need | Perceived need, quantity of care individuals themselves feel that they need determined by the public or a patient |
| Factors that affect demand | Awareness, Health, Access, Professionals, Technology, Education |
| Awareness | Knowledge of the patient (everyone as access to the internet) |
| Health | The population, in general, continues to age (baby boomers) |
| Access | Not everyone can have dental care (Location: no providers in the ares, Finances: expensive, no insurance; resources, qualified professionals) |
| Professionals | More professionals are specializing or moving into different fields (limiting the number of general providers) |
| Technology | The latest & greatest equipment is very costly (that cost is passed onto the consumer) |
| Education | Mandated education: continuing education, licensure, the ability to become licensed... |
| Initial care | The meeting of accumulated dental needs at the time a population is taken into a program |
| Maintenance care | The detection and correction of new increments of dental disease on a semiannual/periodic basis |
| Comprehensive care | Initial care + Maintenance care + Preventive measures |
| Financial cost ratio | 5:1 (It costs $5 for initial care compared to $1 for maintenance care --- for every $1 spent on maintenance, $5 will be spent on initial care) |
| Seat time cost ratio | 3:1 (It takes 3 hours for initial care compared to 1 hour of maintenance care --- a prophy may be 1 hour vs. endodontic therapy may be 3 hours) |
| Is it more or less expensive to treat patients that do not have regular recall appointments? | More expensive -- More money & more seat time |
| What is the #1 barrier to care? | Fear |
Created by:
jridder25