Future research is encouraged to elucidate the extent to which scientific progress is improved through systematic compared with narrative reviews.

Increasingly more responsive and accountable health care systems are demanded, which is characterized by transparency and explicit demonstration of competence by health care providers and the systems in which they work. This study aimed to establish measures of oral health for transparent and explicit reporting of routine data to facilitate more patient-centered and prevention-oriented oral health care. To accomplish this, an intermediate objective was to develop a comprehensive list of topics that a range of stakeholders would perceive as valid, important, and relevant for describing oral health and oral health care. A 4-stage approach was used to develop the list of topics: 1) scoping of literature and its appraisal, 2) a meeting of experts, 3) a 2-stage Delphi process (online), and 4) a World Café discussion. The aim was to create consensus through structured conversations via a range of stakeholders (general dental practitioners, patients, insurers, and policy makers) from the Netherlands, Germany, the United Kingdom, Ireland, Hungary, and Denmark. The study was part of the ADVOCATE project, and it resulted in a list of 48 topics grouped into 6 clusters: 1) access to dental care, 2) symptoms and diagnosis, 3) health behaviors, 4) oral treatments, 5) oral prevention, and 6) patient perception. All topics can be measured, as they all have a data source with defined numerators and denominators. This study is the first to establish a comprehensive and multiple-stakeholder consented topic list designed for guiding the implementation of transparent and explicit measurement of routine data of oral health and oral health care. Successful measurement within oral health care systems is essential to facilitate learning from variation in practice and outcomes within and among systems, and it potentiates improvement toward more patient-centered and prevention-oriented oral health care.

Equipping health systems with suitable incentives for efficient resource allocation remains a major health policy challenge. This study examines the impacts of 2015 regulatory changes in Danish dental care which aimed at effectuating a transition from six‐to‐twelve‐monthly dental recall intervals, for every patient, towards a model where patients with higher need receive dental recalls systematically more frequently than patients with lower need. Exploiting administrative data from the years 2012‐2016 from the Danish National Health Insurance database containing 72,155,539 treatment claims for 3,759,721 unique patients, we estimated a series of interrupted time‐series regression models with patient‐level fixed‐effects. In comparison to the pre‐reform period, the proportion of patients with recall intervals of up to 6 months was by 1.2%‐points larger post‐implementation; that of patients with 6‐12‐monthly recalls increased by 0.7%‐points; that of patients with more than 12‐monthly dental recalls decreased by 1.9%‐points. The composition of care shifted more substantially: the proportion of treatment sessions including preventive care increased by 31.5%‐points (95%‐CI: 31.4;31.6); that of sessions including scaling increased by 24.1%‐points (24.0;24.2); that of sessions including diagnostics decreased by 34.5%‐points (34.4;34.6). These findings suggest that dental care providers may have responded differently to regulatory changes than intended by the health policy.

ObjectivesOral diseases are highly prevalent worldwide and their treatment places considerable economic burden on individuals and society. The ADVOCATE (Added value for Oral Care) project aims to promote new, patient-centred preventively oriented primary care and treatment.As part of the project, a benchmarking dashboard is being developed to give stakeholders (i.e. health professionals, policy makers and health service planners) access to routinely collected data through a number of indicators such as: the types of care provided, costs of care and care outcomes, enabling comparisons across countries to be made. ApproachAt the core of the ADVOCATE project, health data from several European countries are being collected. A bidirectional approach is used. Routinely collected claims data from 9 health insurers (insurance companies and NHS schemes) are being gathered. Concurrently, a patient e-questionnaire is being developed. Patients will be asked to answer additional health information questions anonymously whilst in the dental practitioner's office using an app, thus providing data that isn't available through the routinely collected claims data.A previously developed set of indicators is being implemented in an electronic benchmarking dashboard. With the help of the linkage of aggregated forms of both claims data and data from the patient e-questionnaire, the dashboard will be used to visualize these indicators in order to monitor, direct and evaluate system change and related behaviors of patients, professionals, policymakers and insurers. ResultsA pilot version of a dental healthcare dashboard has been developed using data from the Survey of Health, Aging, and Retirement Europe (SHARE).In this context, the number of remaining teeth (indicating oral health status), the proportion of replaced teeth (indicating restorative activity of dentists) and the mean number of dentist visits per day (indicating oral health awareness of the population) were modeled and visualized for 12 European countries and Israel, resulting in highly diverse country groups in terms of the above indicators. ConclusionThe ADVOCATE oral healthcare dashboard, containing essential information from both claims data and data from a patient e-questionnaire (via an app), can be used to review compliance with best practice guidelines and help close the guideline implementation gap. It will be the first time that oral health professionals, insurers, and health policy makers will have the opportunity to review oral health care performance against standards.