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Integration of primary care dental and medical services: a three-year study
M G Haughney1, J C Devennie, L M Macpherson
1Dental Public Health Sciences, University of Glasgow Dental School.
Objective:
To develop and evaluate a model of integrated primary dental and medical care.
Design:
3-year prospective study.
Setting:
A general dental practice and a general medical practice occupying the same building in Glasgow.
Intervention:
Regular staff meetings, joint use of patient records systems and information derived from patient questionnaires. Dentistry was included in established screening programmes such as child health surveillance and care of elderly. Staff were encouraged to participate in joint work practices and joint consultations were carried out.
Main Outcome Measures:
Patient registration, avoidance of discrepancies in information, reduction of secondary referrals, joint work practices.
Results:
The number of registered joint patients attending both medical and dental practices increased by 90%. The joint use of patient record systems avoided discrepancies in patient information which would have affected the quality of patient care. Including dentistry in child health surveillance and care of elderly screening programmes resulted in an increase in 0-5 year olds registering with dentists from 36% to 68% (P < 0.001) and with > 75 year olds from 47% to 71% (P < 0.001). Joint consultations reduced the need for secondary referrals.
Conclusions:
This model of health care demonstrated the potential for coordination and integration of functions between the dental team and the primary care team. Integrated primary dental and medical care requires attitudinal change in health care professionals and requires greater emphasis in education and training of health care professionals in the future.