TY - JOUR

T1 - Direct access to midlevel dental providers

T2 - an evidence synthesis

AU - Brocklehurst, Paul

AU - Mertz, Beth

AU - Jerković-Ćosić, Katarina

AU - Littlewood, Anne

AU - Tickle, Martin

N1 - © 2014 American Association of Public Health Dentistry.

PY - 2014/12/13

Y1 - 2014/12/13

N2 - OBJECTIVES: Direct access is a term that describes the ability of patients to seek health care from midlevel dental providers (MLDPs) without first seeing a dentist. The objective of this study was to synthesize the evidence for the effects and costs of direct access to MLDPs in a primary dental care environment and assess the attitudes of various stakeholders to this method of care delivery.METHODS: The literature was examined for descriptive, observational, and experimental study designs to examine the evidence for direct access in dentistry. Electronic searches were undertaken of the Database of Abstracts of Reviews of Effectiveness, bibliographic subscription databases, open access databases, and the gray literature.RESULTS: The search identified 371 records, although the extent of experimental evidence was limited. The majority of included studies were descriptive and recorded the subjective views of different stakeholders, following the introduction of the policy.CONCLUSIONS: The limited extent of experimental evidence regarding direct access to MLDPs contrasts with their widespread use across Europe, the United States, and the southern hemisphere. Suggestions are made for a research program to improve the evidence base for direct access.

AB - OBJECTIVES: Direct access is a term that describes the ability of patients to seek health care from midlevel dental providers (MLDPs) without first seeing a dentist. The objective of this study was to synthesize the evidence for the effects and costs of direct access to MLDPs in a primary dental care environment and assess the attitudes of various stakeholders to this method of care delivery.METHODS: The literature was examined for descriptive, observational, and experimental study designs to examine the evidence for direct access in dentistry. Electronic searches were undertaken of the Database of Abstracts of Reviews of Effectiveness, bibliographic subscription databases, open access databases, and the gray literature.RESULTS: The search identified 371 records, although the extent of experimental evidence was limited. The majority of included studies were descriptive and recorded the subjective views of different stakeholders, following the introduction of the policy.CONCLUSIONS: The limited extent of experimental evidence regarding direct access to MLDPs contrasts with their widespread use across Europe, the United States, and the southern hemisphere. Suggestions are made for a research program to improve the evidence base for direct access.

KW - Cost-Benefit Analysis

KW - Dental Health Services

KW - Evidence-Based Dentistry

KW - Health Services Accessibility

KW - Humans

KW - Patient Safety

KW - Patient Satisfaction

KW - Journal Article

KW - Review

U2 - 10.1111/jphd.12062

DO - 10.1111/jphd.12062

M3 - Article

C2 - 24946834

VL - 74

SP - 326

EP - 335

JO - Journal of Public Health Dentistry

JF - Journal of Public Health Dentistry

SN - 0022-4006

IS - 4

ER -