title: Measuring quality of dental care: Caries prevention services for children.
abstract: BACKGROUND
  The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride.
  
  
  METHODS
  Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance.
  
  
  RESULTS
  Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P < .01); 18% to 37% of children with an elevated risk of experiencing caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P < .01) compared with sealants for 10- to 14-year-olds (range, 8.4-11.1%; χ(2) = 22.7; P < .01), overall sealant placement rates were lower for 10- to 14-year-olds.
  
  
  CONCLUSIONS
  These evidence-based, caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data.
  
  
  CONCLUSIONS
  The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention services.
authors.forename: Jill Boylston
authors.initials: JB
authors.lastname: Herndon
authors.forename: Scott L
authors.initials: SL
authors.lastname: Tomar
authors.forename: Frank A
authors.initials: FA
authors.lastname: Catalanotto
authors.forename: Nancy
authors.initials: N
authors.lastname: Rudner
authors.forename: I-Chan
authors.initials: IC
authors.lastname: Huang
authors.forename: Krishna
authors.initials: K
authors.lastname: Aravamudhan
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Shenkman
authors.forename: James J
authors.initials: JJ
authors.lastname: Crall
mesh_terms: D000293:Adolescent; D002648:Child; D019140:Dental Care for Children / Q000592:standards*; D003731:Dental Caries / Q000517:prevention & control*; D055094:Evidence-Based Dentistry / Q000592:standards; D005460:Fluorides, Topical / Q000627:therapeutic use; D006801:Humans; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D019984:Quality Indicators, Health Care / Q000592:standards; D011787:Quality of Health Care / Q000592:standards*
chemical_list: D005460:Fluorides, Topical; D010895:Pit and Fissure Sealants
keywords: Quality of care; caries prevention; performance measure