title: Impact of infrastructure on graduate dental education and dental clinic productivity.
abstract: Using all-inclusive data from 126 U.S. Department of Veterans Affairs health care facilities that provide dental services, this study identified the staffing infrastructure under which the Veterans Health Administration can provide graduate dental education without compromising dental clinic productivity. From regression analyses, we found that teaching residents has a negative impact on staff dentists' productivity; however, when the dental assistant to provider ratio is greater than or equal to 1.0, dental residents' workload contribution can offset the negative impact on overall clinic productivity. In the presence of dental residents, the dental assistant, front-desk personnel, and dental treatment room to provider ratios have a positive impact on productivity. The optimal ratios were calculated as 1.5 for dental assistants, 2.1 for dental treatment rooms, and 0.57 for front-desk personnel.
authors.affiliation: FACHE, Washington, DC 20420, USA. hwai-tai.lam@va.gov
authors.forename: Hwai-Tai C
authors.initials: HT
authors.lastname: Lam
authors.forename: Timothy
authors.initials: T
authors.lastname: Ward
authors.forename: Terry G
authors.initials: TG
authors.lastname: O'Toole
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Arola
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Chang
mesh_terms: D003430:Cross-Sectional Studies; D003726:Dental Assistants / Q000706:statistics & numerical data; D003729:Dental Care / Q000458:organization & administration / Q000706:statistics & numerical data; D003740:Dental Clinics / Q000458:organization & administration*; D003796:Dental Service, Hospital; D003797:Dental Staff / Q000706:statistics & numerical data; D003815:Dentists / Q000706:statistics & numerical data; D004499:Education, Dental, Graduate / Q000458:organization & administration*; D017598:Efficiency, Organizational; D006784:Hospitals, Teaching; D006787:Hospitals, Veterans; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000706:statistics & numerical data; D013663:Teaching / Q000458:organization & administration / Q000706:statistics & numerical data; D014481:United States; D016526:Workload