Research | Published:

Capitation care fee banding: aspects of reliability and validity of an online tool

BDJ 225, 751–755 (26 October 2018) | Download Citation

Subjects

Key points

  • Improves understanding of the practicalities of funding oral healthcare through capitation payments.

  • Illustrates that valid and reliable protocols can be developed to support risk-based banding for capitation payments.

  • Underlines that capitation funding systems facilitate a preventive approach to care for both clinicians and patients.

Abstract

Aim

To investigate aspects of reliability and validity of Denplan/Previser Patient Assessment (DEPPA) capitation fee code guidance through a population study and to discuss some of the practicalities of effective capitation funding.

Methods

A form of 'test-re-test' reliability analysis was conducted on the DEPPA database. The fee code spread for the first 10,000 patients assessed using DEPPA (in 2013) was compared with the most recent 10,000 patients assessed (in 2017). The hypothesis was that, if these two populations, on average, have a similar oral health status it would be expected that the fee code spread should remain in a similar proportion for the two populations. Statistical checks were also performed on the database to confirm that the specific construct of Denplan Care fee code guidance was being represented by results delivered by DEPPA.

Results

The percentage of patients assigned by DEPPA into each of the five fee codes (A–E) remained consistent between the 2013 and 2017 groups. Both groups had the same oral health status as measured by the Oral Health Score (OHS) component of DEPPA (average OHS=78 for both groups). Further statistical analysis suggested that the defined concept of Denplan Care fee code guidance was being represented by DEPPA.

Conclusions

Reliable capitation fee banding increases the viability and fairness of this funding system, which in turn facilitates a preventive approach for both patients and dental teams. Patient assessment systems such as DEPPA can provide reliable and valid capitation fee code guidance.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

Rent or Buy

All prices are NET prices.

References

  1. 1.

    , . A new initiative on precision medicine. N Engl J Med 2015; 372: 793–795.

  2. 2.

    , , , . Disease activity and need for dental care in a capitation plan based on risk assessment. Br Dent J 2000; 189: 480–486.

  3. 3.

    , , , , . The capitation study. 2. Does capitation encourage more prevention? Br Dent J 1990; 168: 213–215.

  4. 4.

    , , . Capitation in dentistry: a quasi-experimental evaluation. Med Care 1977; 15: 228–240.

  5. 5.

    General Dental Council. Standards for the Dental Team. Available at (accessed 2 October 2018).

  6. 6.

    , , , . NHS dental services in England: an independent review. London: Department of Health, 2009.

  7. 7.

    , , , . Novel online integrated oral health and risk assessment tool: development and practitioners' evaluation. Br Dent J 2013; 215: 115–120.

Download references

Author information

Affiliations

  1. Simplyhealth Professionals, The Stables, Heritage Court, Clifton Reynes, Olney, MK46 5FW

    • M. Busby

  2. Oral Health Innovations Ltd, Birmingham Research Park, Vincent Drive Birmingham, B15 2SQ

    • L. Chapple

  3. Simplyhealth Professionals, Simplyhealth House Victoria Road, Winchester, SO23 7RG

    • H. Clover
    •  & J. McCreanor

  4. Birmingham Dental School, 5Mill Pool Way Edgbaston, Birmingham, B5 7EG

    • I. Chapple

Authors

  1. Search for M. Busby in:

  2. Search for L. Chapple in:

  3. Search for H. Clover in:

  4. Search for J. McCreanor in:

  5. Search for I. Chapple in:

Corresponding author

Correspondence to M. Busby.

To obtain permission to re-use content from this article visit RightsLink.

About this article

Publication history

Accepted

Published

DOI

https://doi.org/10.1038/sj.bdj.2018.865