December 2014

Volume 31, Issue 4

Weighing up the Weighted Case Mix Tool (WCMT): a psychometric investigation using confirmatory factor analysis

Authors: R. Freeman K. Gordon E.J. Okeefe D. Richards G. Humphris B.G. Duane
doi: 10.1922/CDH_3430Duane07

Abstract

Weighing up the Weighted Case Mix Tool (WCMT): a psychometric investigation using confirmatory factor analysis Objective: To assess the use of the WCMT in two Scottish health boards and to consider the impact of simplifying the tool to improve efficient use. Design: A retrospective analysis of routine WCMT data (47,276 cases). Clinical setting: Public Dental Service (PDS) within NHS Lothian and Highland. Method: The WCMT consists of six criteria. Each criterion is measured independently on a four-point scale to assess patient complexity and the dental care for the disabled/impaired patient. Psychometric analyses on the data-set were conducted. Conventional internal consistency coefficients were calculated. Latent variable modelling was performed to assess the ‘fit’ of the raw data to a pre-specified measurement model. A Confirmatory Factor Analysis (CFA) was used to test three potential changes to the existing WCMT that included, the removal of the oral risk factor question, the removal of original weightings for scoring the Tool, and collapsing the 4-point rating scale to three categories. Results: The removal of the oral risk factor question had little impact on the reliability of the proposed simplified CMT to discriminate between levels of patient complexity. The removal of weighting and collapsing each item’s rating scale to three categories had limited impact on reliability of the revised tool. The CFA analysis provided strong evidence that a new, proposed simplified Case Mix Tool (sCMT) would operate closely to the pre-specified measurement model (the WMCT). Conclusions: A modified sCMT can demonstrate, without reducing reliability, a useful measure of the complexity of patient care. The proposed sCMT may be implemented within primary care dentistry to record patient complexity as part of an oral health assessment. Key words: special care dentistry, Bateman tool, weighted case mix tool, commissioning

£10 single article

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The European Association of Dental Public Health conference resolution on the control of e-cigarettes; Or “You have to be a bit crazy to carry on smoking conventional cigarettes when there are e-cigar 194-195 £10 single article
Integrating oral health into a dementia care pathway 196-199 £10 single article
Weighing up the Weighted Case Mix Tool (WCMT): a psychometric investigation using confirmatory factor analysis 200-206 £10 single article
Implementation partnerships in a community-based intergenerational oral health study 207-211 £10 single article
Trends and predictors of primary dental care health services for adults in Israel 212-218 £10 single article
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The impact of oral health status on the Oral Health-Related Quality of Life (OHRQoL) of 12-year-olds from children’s and parents’ perspectives 240-244 £10 single article
Validity of a questionnaire in estimating restorative treatment need among young adults 245-250 £10 single article
Validating a measure of the prevalence of dental anxiety as applied to Kuwaiti adolescents 251-256 £10 single article

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