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Case mix

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The users guide contains the following sections;
  • Introduction
  • Criteria and scoring
  • Recording and Analysis
  • Case Mix Data Form

Also provided are;

These are available by navigating the left menu.



Guidance on commissioning for special care dentistry recommends that commissioners appraise themselves of the complex needs of many patients accessing special care dentistry as such contracts must reflect the additional time and resources required to provide care for this group of patients (BSDH 2006). The Department of Health in its publication ‘Valuing Peoples Oral Health recommends that commissioners need information regarding the degree of difficulty in carrying out dental treatment, based on the individual’s impairment or disability and the impact this has on providing a responsive service.

This case mix model is a tool designed to measure patient complexity by using a system of identifiable criteria applied to a weighted scoring system.  The model identifies the various challenges patient complexity can present dental services (such as difficulties in communication or co-operation). These may result in the need for a greater length of time or additional staff to provide care for a particular patient, in comparison to an average member of the population, irrespective of which contract currency is in use to monitor the dental work undertaken.

This model provides a methodology of describing those complex needs, which can then be used to inform contracts.  In time it is expected that its use will become widespread across the country and across different models of dental service provision including secondary care and independent contractors.  This will enable commissioners to benchmark the services provided to their local special needs population and ensure that the services commissioned provide for a full range of these patient’s needs in a way that demonstrates value for money.  It is intended that it be used as one of a number of measures to ensure adequate provision of services for this client group.

The model ranks the complexities presented, and a provisional weighting system has been applied to enable comparisons to be made, for example between different clinician’s caseloads, different clinics, and in time across different services.

Each individual patient episode of care is measured separately, and as such it is anticipated that an individual patient will score differently for different episodes of care reflecting the complexity related to the nature of that episode. In this respect the model is more sensitive than a ‘patient label’ in that it reflects the actual level of resource required and not a theoretical level that is only needed when the patient actually needs active treatment.

Usage of the model is not restricted solely to primary dental care or to the UDA system currently operating in England and Wales.  It is important to emphasize that this is a tool to measure patient complexity.  It is not intended to reflect or be used to give weight to the complexity of the dentistry undertaken.




Case mix data capture form         (64.3 KB)Case mix data capture form         (33.5 KB)
Case mix users guide            (84.67 KB)