Publication:

Primary Care is the gatekeeper for implant provision – who holds the key? (2008)

Author(s): Field JC

    Abstract: Aim: The aims were to i) identify the level of facilitation of implant provision that practitioners within 3 local PCTs would engage in, when presented with a hypothetical case scenario ii) relate practitioner behaviour to demographics and iii) to identify any perceived barriers to each level of facilitation. Subjects and Methods: 362 registered Practitioners in the North-East of England were sent postal questionnaires developed using mixed qualitative methods. Practitioners were presented with a scenario of a patient unable to manage a well made lower denture on a severely resorbed ridge. The questionnaire led them through the decision making/negotiation stages of Implant supported mandibular overdenture (ISMOD) provision (considering, discussing, offering, delivering and referring); at each stage they were asked to select any perceived barriers. Results: 217 responses were received (74% of eligible Practitioners). Most practitioners would facilitate the provision of ISMODs although 11% of Practitioners would never consider ISMODs in this case-based scenario. The main barrier at this stage was the perceived ability of the patient to pay. This was prior to any discussion with the patient. Of those considering ISMODs, all practitioners would discuss them with the patient; 2% would never offer them. Of those offering treatment, 66% would never deliver any treatment themselves with the vast majority (60%) referring to a colleague in primary care. The main barrier to treatment at this stage was the training/experience of the practitioner. Univariate analyses showed significant associations between demographics and behaviour. Younger males were more likely to consider ISMODs in this case-based scenario. Females were less likely to deliver any treatment themselves, and Males were more likely to refer to a colleague in Primary Care. Conclusions: Several significant associations between demographics and Practitioner behaviour were identified, and although most practitioners would (in some way) facilitate the provision of ISMODs in this case-based scenario, these results provide evidence that micro decision-making does occur in relation to resource allocation.

      • Date: 10-13 September 2008
      • Conference Name: European College of Gerodontology Poster Presentations: PEF IADR Conference
      • Publication type: Conference Proceedings (inc. abstract)
      • Bibliographic status: Unknown
      Staff

      Dr James Field
      Clinical Fellow in Restorative Dentistry