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Utilisation of Dental Services by Adolescents

Outcome

Youth are healthy, safe and supported.

Measure

Utilisation of DHB-funded dental services by adolescents from School Year 9 up to and including age 17 years

Type

Contributory measure

Relationship(s) to other frameworks

This measure is part of the DHB non-financial monitoring framework and performance measures (Measure reference: PP12) which is available at: https://nsfl.health.govt.nz/accountability/performance-and-monitoring/performance-measures/final-draft-performance-measures

Delivery of this measure supports the overarching outcomes for the health and disability system of ‘New Zealanders living longer, healthier and more independent lives’, and ‘The health system is cost effective and supports a productive economy’ and the overarching goal that ‘All New Zealanders live well, stay well, get well’.

Rationale

This measure gauges coverage of publicly funded adolescent oral health services in New Zealand – specifically oral health services provided to children and up until their 18th birthday, through:

  • DHBs’ Community Oral Health Services (COHS)
  • DHB-funded contracts with Maori oral health providers to provide child oral health services
  • DHB-funded contracts with private dentists and Maori oral health providers to provide adolescent oral health services.



This measure will provide information that allows Alliances and the Ministry, to evaluate how health promotion and ‘reinvestment’ programmes and services such as the DHB Community Oral Health Service (COHS) and other adolescent oral health providers, are influencing the oral health status of adolescents.

Alliances will be able to identify and target the populations in their district where adolescent oral health utilisation is low.

Eligible population

Adolescents aged 12 to 17 years

Measure status

In development

Measure definition

Numerator

Number of adolescents accessing DHB-funded adolescent oral health services - defined as:

  1. The unique count of adolescent patients’ completions and non-completions under the Combined Dental Agreement; and
  2. The unique count of additional adolescent examinations with other DHB-funded dental services (e.g. DHB Community Oral Health Services, Māori Oral Health providers and other contracted oral health providers).

Denominator

The Ministry will source denominator data, using estimates of DHB population by age (sourced from NZ Census and Statistics New Zealand’s population projections between Census).

The denominator will be calculated as follows:

  • Half of the cohort aged 13 years
  • All of the cohorts aged 14 – 17 years inclusive.

National target

-

Local target

Milestones to be decided by Alliance

Data Sources

  • Combined Dental Agreement (CDA) claims data processed by Sector Services payment processing system – known as ‘Proclaim’
  • NZ Census and Statistics NZ populations projections data

Data extracted from data sources

-

Data availability

Data will be released by the Ministry of Health on a quarterly basis.

To reduce duplication of effort, at the end of each quarter in the year to which the reporting relates, the Ministry will organise a data extract from Sector Services for all DHBs for claims made by dentists contracted under the Combined Dental Agreement, and provide this data for DHBs’ use in determining part (i) of their Numerator.

Measure calculation process

-

Relationship(s) to other measures

This measure sits alongside three other children’s oral health measures which form part of the DHB non-financial monitoring framework and performance measures:

  • Measure PP10: Oral health – Mean DMFT score at Year 8
  • Measure PP11: Children caries-free at five years of age
  • Measure PP13: Improving the number of children enrolled in DHB funded dental service

Measure development notes

DHBs are required to report the numerator and denominator values broken down by:

  1. Ethnicity, using the ‘prioritised ethnicity’ approach¹ into the following (in order of assignment):
    • Māori;
    • Pacific (only for the seven ‘official’ Pacific DHBs); and
    • Other (includes Pacific children in the other DHBs that are not ‘official’ Pacific DHBs).


Part of the data for this measure will be provided by the Ministry and the balance will be generated by DHBs (non-CDA data on adolescents utilising COHS services and DHB-contracted dental services not processed by Sector Services payment processing system).

DHBs have been encouraged to record data at the unit (individual child) level, using the National Health Index – this will need to be enforced if PHO level information is required.

Measure testing/piloting: Not required at this time – it is an existing measure
Implementation timeline: Measure is scheduled to move from a status of ‘in development’ to ‘active’ on 1 July 2018.
Reporting frequency: DHBs and other oral health providers currently provide data on an annual basis – in the fourth quarter of a financial year (i.e. April to June) for the period 1 January to 31 December of the previous year.
Measure implementation group: Service Analysis and Modelling team, Ministry of Health



¹It is acknowledged that use of the “prioritised ethnicity” approach is not consistent with New Zealand’s Statistical Standard for Ethnicity; but it is considered that this approach is acceptable given that:

  • the historical use of this approach in the long-term data series since 1990 and
  • the standard “total response” approach will not provide an accurate picture of the number of children examined by DHBs’ Community Oral Health Service and other contracted third party providers.


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