March 2017

Volume 34, Issue 1

Using the simplified case mix tool (sCMT) to identify cost in special care dental services to support commissioning

Authors: B.G. Duane R. Freeman D. Richards S. Crosbie P. Patel S. White G. Humphris
doi: 10.1922/CDH_4012Duane04


To commission dental services for vulnerable (special care) patient groups effectively, consistently and fairly an evidence base is needed of the costs involved. The simplified Case Mixed Tool (sCMT) can assess treatment mode complexity for these patient groups. Objective: To determine if the sCMT can be used to identify costs of service provision. Clinical Setting: Patients (n=495) attending the Sussex Community NHS Trust Special Care Dental Service for care were assessed using the sCMT. Main Measures: sCMT score and costs (staffing, laboratory fees, etc.) besides patient age, whether a new patient and use of general anaesthetic/intravenous sedation. Method: Statistical analysis (adjusted linear regression modelling) compared sCMT score and costs then sensitivity analyses of the costings to age, being a new patient and sedation use were undertaken. Regression tables were produced to present estimates of service costs. Results: Costs increased with sCMT total scale and single item values in a predictable manner in all analyses except for ‘cooperation’. Costs increased with the use of IV sedation; with each rising level of the sCMT, and with complexity in every sCMT category, except cooperation. Conclusion: Costs increased with increase in complexity of treatment mode as measured by sCMT scores. Measures such as the sCMT can provide predictions of the resource allocations required when commissioning special care dental services. Key words: cost, special care, case mix tool, economics, contract services, diagnosis-related groups, relative-value scales, cost analysis, England


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Editorial 3-3 Download
The oral health of people with learning disabilities - a user-friendly questionnaire survey 4-7 Download
Sugar before bed: a simple dietary risk factor for caries experience 8-13 Download
Measuring oral health impact among care home residents in Wales 14-18 Download
Access to urgent dental care: a scoping review 19-26 Download
Urinary fluoride excretion in preschool children after intake of fluoridated milk and use of fluoride-containing toothpaste 27-31 Download
Directly observed daily mouth care provided to care home residents in one area of Kent, UK 32-36 Download
Association between sense of coherence and oral health-related quality of life among toddlers 37-40 Download
Tobacco use in late adolescence among rural Sri Lankans 41-45 Download
Dental caries experience among Albanian pre-school children: a national survey 46-49 Download
A model for oral health gradients in children: using structural equation modeling 50-55 Download
Using the simplified case mix tool (sCMT) to identify cost in special care dental services to support commissioning 56-59 Download
Oral health and oral health behaviours of five-year-old children in the Charedi Orthodox Jewish Community in North London, UK 60-64 Download


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