June 2013

Volume 30, Issue 2

Operationalisation of the construct of access to dental care: a position paper and proposed conceptual definitions

Authors: R.V. Harris
doi: 10.1922/CDH_3042Harris08

Abstract

Background: ‘Access’ is a term readily used in a political and policy context, but one which has not leant itself to measurement of progress towards policy goals or comparisons between health systems. Like ‘quality’, ‘access’ is a multi-dimensional construct, but currently often remains a vague and abstract concept which is difficult to translate into something specific, concrete and therefore measureable. Methods: The paper describes previous work and identifies a need for a greater consensus and conceptual clarity in the selection of metrics for dental access. Results: The construct of dental access is described as involving the concepts of 1: opportunity for access; 2, realised access (utilisation); 3, equity and 4, outcomes. Proposed conceptual definitions are given and a case made for measuring ‘initial utilisation’ separately from ‘continued utilisation’, reflecting modern approaches which distinguish ‘entry access’ (gaining entry to the dental care system), from the process of gaining access to higher levels of care. Using a distinction between ‘entry access’ and ‘effective access’ allows a choice of whether to restrict measurement to mainly supply side considerations, or alternatively to extend the measurement to include whether there is equity in the proportion of patients who are able obtain effective needed interventions. Conclusions: A development of conceptual definitions of dental access could facilitate measurement of progress towards policy goals and operationalisation of the construct. Key Words: access; equity; dental services; health policy; operationalisation, privatisation

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Other articles in this issue

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Editorial - What has oral health related quality of life ever done for us? 66-67 £10 single article
Dental Public Health in Action - Advice on Methadone and Oral Health: Dental Public Health in Action 68-70 £10 single article
Barriers and facilitators that influence the delivery of prevention guidance in health service dental practice: A questionnaire study of practising dentists in southwest England 71-76 £10 single article
Care home managers’ views of dental services for older people living in nursing and residential homes in inner city London 77-82 £10 single article
High acuity GIS comparison of dentist and doctor surgery locations in Auckland, New Zealand 83-87 £10 single article
Automated coaching to help parents increase their children’s brushing frequency: an exploratory trial 88-93 £10 single article
Operationalisation of the construct of access to dental care: a position paper and proposed conceptual definitions 94-101 Download
Analysis of the perceived oral treatment need using Andersen’s behavioural model 102-107 £10 single article
Caries diagnosis: agreement between WHO and ICDAS II criteria in epidemiological surveys 108-111 £10 single article
Sociodemographic differences in oral health-related quality of life related to dental caries in Thai school children 112-118 £10 single article
Evaluating the Provision of Oral Health Education Material in Schools in Finland 119-123 £10 single article
Short Communication - The cross cultural adaptation and validity of the Child-OIDP scale among school children in Karnataka, South India 124-126 £10 single article
Short Communication - Defluoridation techniques implemented by the government of Karnataka, India – the current situation 127-128 £10 single article

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