Situational Analysis of European and International Oral Health Policy Making for Quality Improvement

Abstract

Introduction: Despite increasing dental expenditures, the burden of oral diseases has not decreased. The room for improving the quality of oral health care (OH) remains large. The purpose of this study was to explore the current understanding, needs, efforts, and actions in European and global policy making for oral health quality improvement. Methods: Drawing from qualitative methodology comprising desk research and semi-structured interviews, a situational analysis was carried out. Interviews with experts in international oral health policy were recorded, transcribed, and analyzed inductively and iteratively. Results: The interviews with 13 participants representing 11 organizations provided diverse insights into policy making for improving the quality of OH. Thematic analyses identified 4 main themes: (1) perception and understanding of quality improvement (QI) in OH policy making, (2) prioritization of QI, (3) efforts and actions for QI, and (4) stakeholder engagement. Three maps were also generated: situational map, social world map, and positional map. Participants acknowledged several facilitators and barriers and provided QI ideas but also expressed concerns. They said that QI was underserved and not properly prioritized. Competing goals and financial limitations were considered major barriers for QI. Some organizations described that they are involved in OH QI and took various initiatives to improve quality, whereas others acknowledged that QI efforts could be expanded. Participants also expressed a necessity for better coordination among stakeholders and joint action on QI to enhance the overall OH of the population in Europe and globally. Conclusions: The findings of this study suggest that there is substantial room for improvement in European and global policy making concerning the QI of OH. While stakeholders seem to recognize the relevance of OH QI, competing priorities and limited resources seem to be perceived as barriers to scaling up QI efforts. The potential of international synergies in QI for OH is emphasized. Knowledge Transfer Statement: The findings of this study provide valuable insights for decision makers and stakeholders who aim to improve oral health care policy making to optimize oral health care in Europe and beyond by offering a deeper understanding of the current situation of international quality improvement efforts for oral health care.