Evaluation of oral health services for adults

Evaluation is carried out to ascertain the value of something, or to compare accomplishments with some standard. Its purpose is to judge and improve the quality, effectiveness and efficiency of services. Oral health services for adults have been dominated by demand-led private practice arrangements. Classic programme evaluation, including assessment of appropriateness, adequacy, effectiveness, efficiency and side-effects has not been possible because neither objectives, nor activities to attain them have been defined. After presenting some evaluative studies of the past, this paper outlines one monitoring and evaluative strategy based on the mixed-scanning theory of planning. The strategy consists in defining a few oral health status and behavioural goals for four selected age groups of adults. Information concerning background and outcome variables is then collected at predetermined intervals of time from random samples of the adult population using a comparatively simple survey strategy. In order to keep the work-load and resource expenditure within reasonable limits, the periodic monitoring surveys would need to be supplemented by ad hoc studies for specific health services research purposes. The periodic surveys would be used to show the extent of goal attainment at predetermined points in time; the ad hoc studies for testing hypothesis about causal associations.