DZZ International, 03/2019

Pulpotomies are primarily carried out as a measure to maintain vitality of juvenile permanent teeth whose roots have not yet fully developed. The indications range from partial pulpitis to complex crown fractures to pulp polyps.

Health services research develops, describes, clarifies, and evaluates health service processes, outcomes and relevant factors that impact on service provision. A consumer/patient focus, contextual relevance and population-relevant pa-rameters in addition to individual-level assessments as well as multidisciplin-arity and multiprofessionalism are characteristic features of health services research. The relevance of health services research in Germany is increasing. Dental health services research should aim to (1) develop innovative, cross-disciplinary care concepts and to implement them, (2) consider the common risk factor approach and dentistry's role in medical services, (3) focus on consumer/patient preferences, and (4) target social and regional health inequalities. To allow methodologically robust and thematically broad evaluations, dental health services research in Germany needs to professionalize and to link with relevant actors in the healthcare system. Keywords: effectiveness, evidenc-based medicine, healthcare policy, methods, public health, research levels

Introduction: The majority of dental care in Germany is provided by dentists contracting with national health insurance companies. Although the oral health of the German population is steadily improving a comprehensive description and assessment of the care provision is difficult. However, such analyses are fundamental for potential changes in the care delivery process. The aim of this article is to outline the method of routine data analysis as an essential tool for dental care research, thereby illustrating the potential for research using these data. Method/Results: Routine data analyses are research analyses based on data originally collected for other purposes. In the dental context, claims data can illustrate the spectrum of treatment provided. In cooperation with a large German national health insurance company, longitudinal analyses were carried out based on the essential components of dental treatments implemented. Additionally, routine data was used to evaluate system changes and to consider regional differences in treatments. Typical analyses are presented and critically considered. The nature of the database results in methodological restrictions of routine data analyses. The interpretation of the results is also limited because comparative studies and expected values are often missing. Nevertheless, despite these drawbacks, routine data analysis is an important method that leads to a better understanding of care provision. Previously unattainable insights into real care processes are now possible, providing data and results that could not otherwise be generated. Conclusions: The understanding of dental care provision under a national health insurance model is currently still rudimentary. However, this understanding is an impetus for improvement. The presented results based on routine data are the first milestones towards a comprehensive description of the reality of care. Keywords: "Dental care/medical insurance model", data mining, health service research, outcomes, quality, routine data, secondary data, system changes

Dental care in Germany is in the midst of transitioning. This includes a changed epidemiological baseline situation and with that different treatment needs. Additionally, the supply side (dentists) is undergoing a structural change. To ensure appropriate care under these altered conditions, measures of different strategies can be applied. This article is aimed to clarify (a) what evidence is available today to answer this question, (b) how we are going to assess future demand and (c) what essential parameters of future development need to be taken into consideration in order to adjust dental health care so that optimal health can be achieved on a population level. An approach to answering this question in the current state of needs-based dental care in Germany should be made with three key statements. Thesis 1: Currently, it can be assumed that restorative care on a population level is needs-based. However, periodontal care does not seem to meet the needs. Thesis 2: Due to the demographic change, a high treatment demand can furthermore be expected, despite a declining burden of disease in dentistry. Thesis 3: International educational measures, financial intervention, regulatory strategies and/or personal and professional offers of support are discussed as possible control elements to ensure appropriate care in the future. Keywords: care research, demand, demand planning, dentistry, epidemiology