Key Points
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Oral health tends to decline with age and can place a great burden on dental practices caring for older age groups.
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An algorithm for recommending capitation fee bands which map these trends is available.
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Capitation payments can be designed to fund care across a broad range of oral health and future disease risk.
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Planners of care funding must subsidise the care of those in greatest need.
Abstract
Aim The aim of this paper was to review the oral health and future disease risk scores compiled in the Denplan Excel/Previser Patient Assessment (DEPPA) data base by patient age group, and to consider the significance of these outcomes to general practice funding by capitation payments.
Methods Between September 2013 and January 2014 7,787 patient assessments were conducted by about 200 dentists from across the UK using DEPPA. A population study was conducted on this data at all life stages.
Results The composite Denplan Excel Oral Health Score (OHS) element of DEPPA reduced in a linear fashion with increasing age from a mean value of 85.0 in the 17–24 age group to a mean of 72.6 in patients aged over 75 years. Both periodontal health and tooth health aspects declined with age in an almost linear pattern. DEPPA capitation fee code recommendations followed this trend by advising higher fee codes as patients aged.
Conclusions As is the case with general health, these contemporary data suggest that the cost of providing oral healthcare tends to rise significantly with age. Where capitation is used as a method for funding, these costs either need to be passed onto those patients, or a conscious decision made to subsidise older age groups.
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References
Busby M, Matthews R, Chapple E, Chapple I . Continuous development of an oral health score for oral health surveys and clinical audits. Br Dent J 2014; 216: E20.
Chapple I L C, Wilson N H F . Chronic non-communicable diseases. Br Dent J 2014; 216: 487.
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Wilson, N. Summary of: The relationship between oral health risk and disease status and age, and the significance for general dental practice funding by capitation. Br Dent J 217, 576–577 (2014). https://doi.org/10.1038/sj.bdj.2014.1030
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DOI: https://doi.org/10.1038/sj.bdj.2014.1030
