The quality of general dental care: public and users' perceptions

Background-Systematic evidence about how the public and users perceive and experience the quality of general dental care is in short supply, particula rly in light of the recent changes in the general dental service. The study reported here attempted to fill this gap. Objectives-To identify the criteria the public and users adopt in evaluatin g the quality of general dental care, and to identify the extent and nature of perceived concerns with general dental care. Design-Postal questionnaires were sent to random samples of adults living i n an inner city area (I) and semi-rural area (R) in southern England. Fifty six per cent (1499) in area R and 48% (1388) in area I completed the quest ionnaire after four mailings. Follow up face-to-face interviews were done w ith a purposive subsample (n=50) of responders from the postal survey. Main measures-Public/user views about quality of dental care were measured through groups of questions about the importance of and satisfaction with d ifferent aspects of dental care (access/availability including cost; facili ties; technical skills; and interpersonal care) and a scale (Dentsat) measu ring general satisfaction was constructed from questions on different aspec ts of care. Results-Evaluation of quality of general dental care from the u sers' point of view hinges on perceived technical skills, particularly pain management. Major dissatisfaction stems from concerns about costs of denta l care and privatisation. Conclusions-The criteria adopted by the public/users to assess general dent al care are similar to other areas of health care, apart from the priority placed on technical skills and pain management. However, the major source o f decline in satisfaction with the quality of general dental care is the ba rrier to access created by the rising cost of dental care and the increasin g involvement of dentists in private practice. This evidence suggests that the public and users find the drift towards private practice and away from NHS practice a major source of concern.