TY - JOUR

T1 - Productive efficiency and its determinants in the Community Dental Service i nthe north-west of England

AU - Hill, Harry

AU - Tickle, Martin

AU - Birch, Stephen

AU - McDonald, Ruth

AU - Brocklehurst, Paul

N1 - Community Dental Health has kindly given permission to use this article in the institutional repository

PY - 2017/6

Y1 - 2017/6

N2 - Objectives: To assess the efficiency of service provision in the Community Dental Services and its determinants in the North-West of England. Setting and sample: 40 Community Dental Services sites operating across the North-West of England. Basic Research Design: A data envelopment analysis was undertaken of inputs (number of surgeries, hours worked by dental officers, therapists, hygienists and others) and outputs (treatments delivered, number of courses of treatment and patients seen) of the Community Dental Services to produce relative efficiency ratings by health authority. These were further analyzed in order to identify which inputs (determined within the Community Dental Services) or external factors outside the control of the Community Dental Services are associated with efficiency. Main outcome measure: Relative efficiency rankings in Community Dental Services production of dental healthcare. Results: Using the quantity of treatments delivered as the measure of output, on average the Community Dental Services in England is operating at a relative efficiency of 85% (95% confidence interval 77%- 99%) compared to the best performing services. Average efficiency is lower when courses of treatment and unique patients seen are used as output measures, 82% and 68% respectively. Neither the input mix nor the patient case mix explained variations in the efficiency across Community Dental Services. Conclusions: Although large variations in performance exist across Community Dental Services, the data available was not able to explain these variations. A useful next step would be to undertake detailed case studies of several best and under-performing services to explore the factors that influence relative performance levels.

AB - Objectives: To assess the efficiency of service provision in the Community Dental Services and its determinants in the North-West of England. Setting and sample: 40 Community Dental Services sites operating across the North-West of England. Basic Research Design: A data envelopment analysis was undertaken of inputs (number of surgeries, hours worked by dental officers, therapists, hygienists and others) and outputs (treatments delivered, number of courses of treatment and patients seen) of the Community Dental Services to produce relative efficiency ratings by health authority. These were further analyzed in order to identify which inputs (determined within the Community Dental Services) or external factors outside the control of the Community Dental Services are associated with efficiency. Main outcome measure: Relative efficiency rankings in Community Dental Services production of dental healthcare. Results: Using the quantity of treatments delivered as the measure of output, on average the Community Dental Services in England is operating at a relative efficiency of 85% (95% confidence interval 77%- 99%) compared to the best performing services. Average efficiency is lower when courses of treatment and unique patients seen are used as output measures, 82% and 68% respectively. Neither the input mix nor the patient case mix explained variations in the efficiency across Community Dental Services. Conclusions: Although large variations in performance exist across Community Dental Services, the data available was not able to explain these variations. A useful next step would be to undertake detailed case studies of several best and under-performing services to explore the factors that influence relative performance levels.

KW - Dental auxiliaries

KW - Economics

KW - Mid-level provider

KW - Efficiency

KW - Production

U2 - 10.1922/CDH_4028Hill05

DO - 10.1922/CDH_4028Hill05

M3 - Article

VL - 34

SP - 102

EP - 106

JO - Community dental health

JF - Community dental health

SN - 0265-539X

IS - 2

ER -