Do prevention incentive schemes work in dental practice?
PHE ePoster Library. Smith L. Sep 12, 2017; 186557; 3
Lorna Smith
Lorna Smith
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Abstract Introduction Improving child oral health is a priority for Durham Darlington and Tees (DDT) Local Dental Network (LDN). To improve sub-optimal prevention activity the LDN conducted a three-month pilot using financial incentives to increase fluoride varnish; fissure sealant and topical fluoride prescriptions, as recommended in Delivering Better Oral Health. Evaluation of the scheme aimed to assess whether financial incentives influenced preventive practice in DDT dentists. Methods Fluoride varnish and fissure sealant delivery rate trends for three months before, during and after the pilot were analysed using NHS England self-reported dental records. Prescribing rates of topical fluoride were analysed using the self-reported pilot-specific records. Results Forty-one (26%) practices participated between February and April 2015. Findings suggest an association between financial incentives and improved rates of delivery for fluoride varnish and fissure sealants. Topical fluoride prescribing requires improvement. The average rate for fluoride varnish delivery increased by 8.3% to 90.7% during the pilot. Prior to the intervention application rates of fissure sealants were very low at 4% but a large relative increase of 8.6% to 12.6% was found during the pilot. Greater changes to practice were observed in providers in the most deprived settings compared to the least deprived. The improved delivery rates were maintained after the financial incentives ceased for fluoride varnish. Conclusion Delivery of fluoride varnish and fissure sealants was positively influenced by financial incentives at a population level. A sustained changed in practice appears procedure-specific. Commissioners should consider targeting areas with the greatest needs for improvement with tailored incentives.
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