The users guide contains the following sections;
- 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.