national prevention program as a base of the dental care strategy. a.paeglītis cdo head of centre...
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National Prevention Program as a base of the Dental Care Strategy. A.Paeglītis
CDO
Head of Centre of Dentistry and Facial surgery
of Pauls Stradins clinical hospital of University.
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The Strategy of Dentistry included in the Strategy of Latvian Health Treatment is adopted and confirmed with the Government resolution on the 24th September 1996.
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Dental Care Strategy
National Program consists of 5 blocks:
Information-motivation block
Educational block
Scientific block
Preventative block
Data bank block
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Information-motivation block
Competent institution Oral Health Centre
A comprehensive system to educate children and their parents on oral health;
Media involvement – TV, radio, newspapers, magazines, publishing of books, booklets;
Collaboration with various specialists to popularize a healthy life style;
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Evaluation of Oral Health and Accessibility of Dental Services for Children Project of Oral Health Centres (OHC)
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Current Location of OHCs in Latvia:
Regional - 4– novadu Local - 26
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Classes and events in Kinder gardens
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The presentation of Scientific research Works for School grade 6 and 7
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Different Events
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Presentation of Results
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Team of Dentalbus Team of Dentalbus North–East Latvia Oral Health CentreNorth–East Latvia Oral Health Centre
Team of Dentalbus Team of Dentalbus North–East Latvia Oral Health CentreNorth–East Latvia Oral Health Centre
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Lelles
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Drawing competition for school children “Color your
teeth bus !”
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Educational Block Competent institution Oral Health
Centre - development of dental hygienist curriculum and
practical training; - development of specialized preventative educational
programs (for children according to their age groups, pregnant women, new mothers);
- organizing courses, lectures in preventative strategy; - collaboration with the AML – Health School, Youth
Health Centre, specialists of the Base Education System (school-board).
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Scientific Block Competent institution Oral Health
Centre Usage of the epidemiologic data analysis of the ICS-II project to implement and assess the National Prevention Program;
Regular usage of epidemiologic data to assess efficiency of preventative measures;
Performance of regular epidemiologic research.
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1993 2000 2001 2002 2004 2010
5.8
3.93.6 3.5 3.4 3.4
0
1
2
3
4
5
6
KPE pastāvīgiem zobiem 12 gadus veciem bērniem
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KPE for 12-year old children in KPE for 12-year old children in north-east Latvia (1999 -2001)north-east Latvia (1999 -2001)
5,75,4
4,7 4,7
3 2,9
2,2 2,3
3,2
0
1
2
3
4
5
6
Valmiera 793
Valka 336
Cēsis 600
Limbaži 448
Gulbene 437
Madona 563
Balvi 335
Alūksne 391
average3903
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KPE with KPE with 1212 year old year old childrenchildren
(school year 2004/2005)(school year 2004/2005)
2,24
3,47
1,89
2,632,83
2,27
3,31
2,58
0
0,5
1
1,5
2
2,5
3
3,5
Valmiera
Cēsis
Limbaži
GulbeneMadonaBalvi
Alūksneaverage
Number of children 1546
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KPE structure for 12KPE structure for 12 year old, year old, 2007/20082007/2008
0
0,5
1
1,5
2
2,5
3
3,5
4
Kz 1,6 1,71 1,10 1,42 1,08 1,67 1,37 0,96
Ez 0,08 0,05 0,02 0,02 0,03 0,03 0,07 0,09
Pz 1,57 0,86 1,51 1,39 0,74 1,05 0,76 1,37
Latvija* (3,25)
Limbaži (2,61)
Cēsis (2.63)
Madona
(2.83)
Balvi (1.85)
Gulbene
(2.75)
Alūksne
(2.21)
Valka (2.42)
*total number of children 1811; KPE 2.48
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KPE + Ki structure for 12KPE + Ki structure for 12 year year old, old, 2007/20082007/2008
0,00
0,50
1,00
1,50
2,00
2,50
3,00
3,50
Kiz 0,11 0,23 0,29 0,10 0,20 0,13 0,70
Kz 1,71 1,10 1,42 1,08 1,67 1,37 0,96
Ez 0,05 0,02 0,02 0,03 0,03 0,07 0,09
Pz 0,86 1,51 1,39 0,74 1,05 0,76 1,37
Limbaži (2,72)
Cēsis (2.87)
Madona (3.13)
Balvi (1.95)
Gulbene (2.96)
Alūksne (2.34)
Valka (3.12)
Number of children 1811; KPE 2.73
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CCaaries free forries free for 12 year old 12 year old children (1999 – 2001)children (1999 – 2001)
91,10%
8,90%
CariesCaries free
3133 children examined
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CCaries freearies free ((1212 year old children) 2004/2005 year old children) 2004/2005
%number
% 23.51 14.72 32.06 20.96 23.16 26.54 19.23
number 75 24 84 35 63 43 35
Valmiera Cēsis Limbaži Gulbene Madona Balvi Alūksne
Number of children 1546; average % 23.67
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Number of caries free children Number of caries free children in 2007/2008 in 2007/2008 ((1212 year old) year old)
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0%
% 25.1 22.0 19.1 34.7 16.7 29.5 25.8
Limbaži Cēsis Madona Balvi Gulbene Alūksne Valka
Number of children 1811; average 24.7 %
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Preventative Block Competent institution Centre of
Dentistry Implementation of base and individual programs to ensure preventative and medical service for children and youth from 0-18.
Treatment availability, mobile dentistry.
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Preventative Block Competent institution Centre of
Dentistry Regulations No. 1036 ”On Organization and Funding of Health Care”
Classification of manipulation in dentistry
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Accesibility for children and disabled persons
Project of mobile dentistry
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Mobile dental practice
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Kurzeme - Zemgale
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Mobile dental practice for physically disabled persons
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Mobile dental practice
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Data Bank Block Competent institution Centre of
Dentistry Assess efficiency of preventative and medical measures in Latvia, create regular registration of dentistry for particular age groups;
Data collection is carried out by local regional Oral Health Centres (OHC) in collaboration with the State Centre of Dentistry (SCD);
Map development and data analysis is carried out by the OHC, and recommendations are given to the SDC regarding possible program adjustments.
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Data Bank of the State centre of Dentistry and Facial surgery
Register of Enterprises
* Minimum Services in Dentistry* Training of Dental Care Staff
Certification of Dentists
Certification of Dental Nurses
Certification of Dental Assistants
Epidemiological Data
Medical Statistics
Health Compulsory Insurance State Agency (HCISA)
Regional Oral Health Centres
Register of Physicians Private Practices
Register of Dentists
Register of Dental Nurses
Register of Dental Assistants
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Advantages
Structural changes Successful collaboration with the
Oral Health Centre Stabile State information network
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Disadvantages
It is not patient-oriented. It is not service quality, validity and
protection oriented in broader definition.
It is not oriented to dentist protection.
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Conclusions
Agree on unified strategic guidelines among the specialists of the Baltic States
Create a new national strategy for dental care, based on unified guidelines, as well as on experience:
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Conclusions
Apply positive experience of our neighbours; in Estonia E-medicine, in Lithuania – patient protection, etc.
Propose solutions of availability in Latvia: network of Oral Health Centres, mobile dentistry
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Suggestions
Build closer collaboration among the Baltic specialists
Agree on common guidelines Involve Scandinavian specialists-
experts
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Suggestions
Enjoy the life!!!
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Basic principles for good dental health care in the future
Dr. Zane BendikaCentre of Dentistry and Facial Surgery Sigulda, 18.08.2011
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National prevention programm (elaborated in 1995) as a basis of the Dental Care Strategy 2011-2020
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Good care-about the management system for quality and patient safety in health care
Guide issued by the Swedish National Board of Health and Welfare in 2006.
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Health care must be
Patient centred Accessible and timely Safe Evidence based Equitable Efficient
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Patient centred care
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A number of different facts indicates that health care is not always as patient-centred as it should be
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The possible reasons for this include the following:
There is a lack of awareness that a patient-centred approach provides a better outcome
Patients interest in treatment process is not always sufficient
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What needs to be improwed?
Legislation (Law on the Rights of Patients 1.03.2009)
Freedom of choice The formats for patient participation in health
care need to be developed
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What needs to be improved?
Need for indicators and methods that measure individuals’needs and prerequisites
Information provided for the public and communication with patients and the public about the processes and results of health care must be improved
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Timely care
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Care is offered to patients, without waiting time having an adverse physical, mental or social effect on the patient
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Timely care in dentistry
Acute cases
Follow-up assistance
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Timely=accessible care
Regional accessibility/mobile dentistry
Financial accessibility
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Regional accessibility
Work of the Oral Health Centres Mobile dentistry
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Current Location of OHCs in Latvia:
Regional - 4
Local - 26
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Mobile dental practice
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Financial accessibility
Risk groups:
disabled elderly unemloyed
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Safe care
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Safe care is fundamental to high-quality health care, in wich the treatments used lead to the expected results, without causing risks or injuries to patients
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What needs to be improwed?
Infection control
Radiology
Personal data protection
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Evidence based care
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Health care is based on systematically gathered, scrutinised, evaluated and compiled scientific knowledge
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What needs to be improved?
Recomendations need to be developed within the areas where research is not yet particularly extensive
The production of knowledge should be coordinated in order to avoid duplication of work and contradictions
Monitoring and improvement of medical technologies
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Equitable care
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Health is not distributed equally and thus a health care system should strive towards equity in health care for the entire population and it should prioritise those with the greatest need. It should also be oriented towards prevention and health promotion
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What neds to be improved?
The role of health care in decreasing the disparities in health should be emphasised more
Understanding and knowledge of their connections between social vulnerability and ill health care are very imortant
Equity of care must be monitored and analysed locally, regionally and nationally
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Efficient health care
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Efficient health care means optimal utilisation of the recources available in order to achieve desired goals. Efficient health care can therefore be said to have a high level of target attainment in relation to the recources utilised
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What needs to be improved?
Health services must be oriented to health improvement and prevention
Health care providers need to develop clear incentives to stimulate cooperation and teamwork
Follow-up at individual level, unit level, health care provider level and national level is a prerequisite for analysis of effectiveness and efficiency as a whole