Pathways to orthodontic care

Kisely, Stephen, Howell, Karen and Green, John (1997) Pathways to orthodontic care. Journal of Public Health Medicine, 19 2: 148-155.

Author Kisely, Stephen
Howell, Karen
Green, John
Title Pathways to orthodontic care
Journal name Journal of Public Health Medicine   Check publisher's open access policy
ISSN 0957-4832
Publication date 1997-06
Sub-type Article (original research)
Volume 19
Issue 2
Start page 148
End page 155
Total pages 8
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Background. The research described in this paper arose out of the need to address the growing waiting list for orthodontic treatment in Northamptonshire. Although the prevalence of dento-facial anomalies is the same across time, sex, race and socio-economic class, studies in the United States and this country suggest that certain groups are over-represented among patients who receive orthodontic treatment. The introduction of valid and reliable indices of therapeutic need such as the Index of Orthodontic Treatment Need (IOTN) will allow improved focusing of services. The aim of the study was to determine the variables affecting access to orthodontic care, and the extent to which services were delivered according to objective measures of need.

Methods. Analyses were undertaken for speed, appropriateness, timing of referral, duration and complexity of the pathway for new referrals to specialist orthodontic care. Possible explanations for the length of pathway were examined, including socio-demographic factors, location of residence and the IOTN.

Results. A total of 405 patients were approached, of whom 400 (99 per cent) agreed to participate. There was an over-representation among socio-economic groups I and V among patients referred to orthodontic treatment. By contrast, those of male sex and from socio-economic class IV were under-represented. This appeared to be the case irrespective of treatment setting. There was also a wide range of waiting times to treatment and complexity of pathway. Over a quarter of the sample had been inappropriately referred, and objective need as measured by the IOTN was not a determinant in the speed of access to specialist treatment. Adult patients waited longer for treatment.

Conclusions. These results suggest that the delivery of care is neither based on objective need nor equitably distributed. More appropriate directing of resources is required, using the IOTN and agreed protocols, so that referrals are made to the most suitable provider.
Keyword Referral pathways
Orthodontic services
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Health and Rehabilitation Sciences Publications
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Created: Wed, 18 Nov 2009, 12:19:54 EST