Identifying Persons with Special Healthcare Needs in Dentistry—Development and Validation of the French Case Mix Tool

Denise Faulks (), Marie-Sophie Bogner, Solenn Hamon, Caroline Eschevins and Bruno Pereira
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Denise Faulks: Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63100 Clermont-Ferrand, France
Marie-Sophie Bogner: Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63100 Clermont-Ferrand, France
Solenn Hamon: Dental Surgery, 2 Rue de la Poudrette, 69100 Villeurbanne, France
Caroline Eschevins: Service d’Odontologie, CHU Clermont-Ferrand, 63000 Clermont Ferrand, France
Bruno Pereira: Direction de la Recherche Clinique et de l’Innovation, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France

IJERPH, 2023, vol. 20, issue 4, 1-13

Abstract: Providing dental care for certain patient groups is complicated due to difficulties with cooperation, communication, health conditions, and social context, amongst others. The majority of dentists in France work within a public fee-per-item system. A new measure has been introduced providing a financial supplement to dentists for each episode of care for a patient with a severe disability. This supplement is justified by completion of the French Case Mix tool (FCM), a new measure designed to retrospectively identify episodes of dental care that have required adaptation and additional time or expertise. The aim of this study was to investigate the validity and psychometric properties of the FCM. The content validity of the tool was improved at each round of pilot development, involving 392 patient encounters. Test–retest data at 2 weeks for 12 fictional patient treatment episodes were collected from 51 dentists. This phase confirmed inter- and intra-dentist reproducibility, criterion validity, and interpretability. Retrospective analysis of 4814 treatment episodes nationally demonstrated high reliability, internal consistency, and construct validity. Overall, the FCM showed high validity and good psychometric properties. However, the impact of providing a financial supplement on improving access to care for persons with special needs has yet to be evaluated.

Keywords: disabled persons; oral health; public health dentistry; health services research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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