Evaluation of different oral care systems: Results for Germany and selected highly developed countries. An update of a former study

Objective: Evaluation of different types of oral care systems by means of new analytical tools that facilitate the obtention of quantifiable results.Methods: Construction of an expanded composite indicator that measures dental health on a population basis in the form of one overall indicator -the Dental Health Index (DHI).If the DHI is combined with a Dental Care Cost Index (DCCI), an efficiency index can be created.The study uses additional contemporary outcome data. Results:The Swedish population enjoys by far the best dental health status.Successive ranks are occupied by Denmark, Germany, Canada, the United Kingdom, the USA and Japan, whereby the DHIs for these countries differ only slightly.The Dutch and Finnish populations enjoy a lesser degree of dental health.Advanced oral health can be achieved in any oral healthcare system, irrespective of the funding structures.However, the design of an oral health system matters, when it comes to patient satisfaction.On the basis of this criteria, European insurance-based systems perform better.The type of care system also matters, when efficiency considerations come into play.In these instances, national health systems seem to perform better.Conclusion: Across systems, the comparison shows that systems strengthening preventive and tooth-preserving strategies, inclusive of adults, progress faster and perform better in respect of effectiveness and efficiency.A macroeconomic cost level of between 0.5% and 0.7% of GDP can be regarded as a benchmark for an efficient dental care system in affluent societies.