Research | Published:

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

BDJ volume 225, pages 751755 (26 October 2018) | Download Citation

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.



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.


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.


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.


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.

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Author information


  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


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Corresponding author

Correspondence to M. Busby.

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