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A survey of referral patterns to a paediatric dentistry unit over a 2-year period
A J Shaw1, J H Nunn, R R Welbury
1Department of Child Dental Health, University of Newcastle upon Tyne, England.
Insights
Referrals for specialist pediatric dental care doubled after 1990 UK payment system changes. Behavior problems were the most common reason, with referrals increasing significantly from recent general dental practitioners.
Area of Science:
- Pediatric Dentistry
- Dental Public Health
- Healthcare Policy
Background:
- UK General Dental Service implemented significant payment system changes for children's dental treatment in October 1990.
- Concerns were raised regarding potential impacts of these changes on various dental specialties.
- Effective targeting of specialist services requires understanding referral patterns.
Purpose of the Study:
- To investigate referral trends of children to specialist care at the Department of Child Dental Health in Newcastle upon Tyne post-1990 payment system alterations.
- To inform more effective targeting of consultant clinics and the provision of advice and treatment for pediatric dental patients.
Main Methods:
- Analysis of 513 referral letters and hospital records for pediatric dental patients between March 1991 and March 1993.
- Exclusion of referrals for orthodontics, extractions under general anesthesia, and acute emergencies.
- Data collection focused on referral source, patient demographics (proximity to hospital), and reasons for referral.
Main Results:
- The number of referrals more than doubled over the 2-year survey period.
- 83% of referred patients resided within a 15-mile radius of the hospital.
- 84% of referrals originated from general dental practitioners, particularly those who graduated within the preceding 4 years; behavioral issues were the most frequent referral reason.
Conclusions:
- The observed increase in referrals and the characteristics of referring practitioners suggest a potential link to the 1990 payment system changes.
- Behavioral problems represent a significant driver for specialist pediatric dental referrals.
- Findings support the need for targeted support and resources for general dental practitioners managing pediatric patients, potentially influenced by policy shifts.
Abstract:
Following the changes in October 1990 in the payment system for children's dental treatment within the General Dental Service in the UK there has been widespread concern that repercussions would be felt in other branches of dentistry. The aim of this survey was to investigate the referral of children for specialist care to the Department of Child Dental Health in Newcastle upon Tyne after the changes in 1990, so that consultant clinics and the provision of advice and treatment could be targeted more effectively. Information was obtained from the patients' referral letters and from their hospital records between March 1991 and March 1993. There were 513 referrals (excluding those for orthodontic treatment, extractions under general anaesthesia and acute emergencies), the number more than doubling during the 2-year survey period. 83% of these patients lived within 15 miles of the hospital. 84% of these referrals were from general dental practitioners, and the greater proportion were from those who graduated within the previous 4 years. The most common reason for referral involved behaviour problems. Changes in the payment system that occurred in 1990 may have been a contributory factor in explaining these findings.