The Patient-Centered Dental Home: A Framework for Quality Measurement, Improvement, and Integration

Area of Science:

• Oral health services research
• Health services research
• Health quality measurement

Background:

• The patient-centered medical home (PCMH) model has improved primary care.
• Integrating dental care into a patient-centered dental home (PCDH) model requires standardized evaluation tools.
• Prior work established the PCDH definition, characteristics, and components.

Purpose of the Study:

• To develop a standardized, 4-level measurement framework for the patient-centered dental home (PCDH).
• To align the PCDH framework with the patient-centered medical home (PCMH) for integrated care.
• To identify and validate measure concepts, measures, and standards for PCDH implementation and evaluation.

Main Methods:

• Conducted an environmental scan of over 500 existing oral health care measures and standards.
• Utilized a modified Delphi process with a National Advisory Committee (NAC) for structured feedback.
• Employed a 9-point rating scale to assess measure concepts (importance) and specific measures/standards (feasibility, validity, actionability).

Main Results:

• Identified and rated 61 measure concepts and 47 measures and standards for the PCDH framework.
• Four rounds of Delphi process refined the selection based on NAC ratings and qualitative comments.
• The final framework comprises 4 levels, enabling the development of core measure sets.

Conclusions:

• The 4-level PCDH measurement framework is now complete, facilitating PCDH implementation and evaluation.
• This framework supports quality improvement initiatives and the integration of dental and medical care.
• Stakeholders can use this framework to guide and assess PCDH adoption and dental-medical integration.