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Filling the Gap: Running a large scale clinic

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Publié le

Oct 24th 2016

Publié dans : Santé
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Filling the Gap: Running a large scale clinic

  1. 1. Filling the Gap: Running a large scale clinic Dr. Alyssa Hayes BDent (Hons), MSc, FRCD(C) College of Dentistry, University of Saskatchewan alyssa.hayes@usask.ca
  2. 2. Outline  Demand for care  Filling the Gap Clinic  Lessons Learned  Future Directions
  3. 3. Health of Immigrants and Refugees in Saskatchewan2 Category DMFT (mean) Perceived Barriers to Care Immigrants (Pakistan) 3.52 (1.55 FT) Lack of Money (14%) Lack of Insurance (14%) Refugees (Burma) 5.80 (0.48 FT) Lack of Money (32%) Lack of Insurance (24%) 2 Hoover J, Vatanparast H, Uswak G. Risk determinants of dental caries and oral hygiene status in 3-15 year-old recent immigrant and refugee children in Saskatchewan, Canada: A pilot study. J Immigrant Minority Health 2016. doi 10.1007-s10903-016-0452-9
  4. 4. Demand for Care  Saskatchewan received over 1,000 Syrian refugees1  Over 400 in the Saskatoon area  Refugee Clinic (Joint Initiative between SODS and GGP)  Initial check up and vaccinations  Referrals as need  Oral health needs identified 1http://www.cbc.ca/news/canada/saskatchewan/1094-syrian-refugees-saskatchewan-1.3471906
  5. 5. Filling the Gap Clinic  College of Dentistry (CoD) response to a need within Saskatoon and surrounding area  Began within three weeks of being asked  Academic year was just ending  Ran clinic from May 3rd to 11th  Needed to develop a system to handle large scale referrals  Consultations with:  Settlement groups  Clinic director and staff  Local dental society
  6. 6. Filling the Gap Clinic
  7. 7. Filling the Gap Clinic – Initial Process Settlement Agency Referral CoD contacted settlement agency with appointment time Settlement agency advised patient and arranged taxi CoD ensured interpreter on site for appointment IFHP benefits maximized Patient rebooked if needed CoD became dental home
  8. 8. Filling the Gap Clinic  To help remove additional barriers to care the CoD provided:  Interpreters  Travel (initial appointments)  Treatment provided by:  Three 4th year students  Supervision by community dentists  Provided treatment for 112 patients  Care provided on a family basis (2-12 people)  Provided over $15,000.00 in treatment
  9. 9. Overview of Treatment Provided  Adults (n=49)  19 + years  Most common findings  Pain  Caries  Periodontal disease
  10. 10. Overview of Treatment Provided  Child Population (n=63)  0-18 years  Most common findings  Pain  Early Childhood Caries (incl. severe)  Extractions  Orthodontic treatment  All needed oral hygiene instruction, education around the oral health care system
  11. 11. Overview of Treatment Provided  Most common codes  01205 (emergency exam)  02111/02112/02142/02601 (radiographs)  20111 (caries, trauma and pain control)  21221/21212/21223 (restorations)  71101/71109 (extractions)  Referrals for:  Surgical extractions  General anesthetic
  12. 12. Filling the Gap Clinic – Early Lessons  Logistical challenges  Difficulty in dealing with Medavie Blue Cross  Up to 7 weeks for pre-determinations (pre-D)  Need ≠ Demand  Removal of barriers ≠ Utilization  Refusal of treatment  Arabic language oral health material needed
  13. 13. Filling the Gap Clinic – Early Lessons  Confusion around IFHP coverage  Education of students, staff and faculty  Expectations around delivery and costs of oral health care  More efficient process needed to be developed  Thought required about long term provision of care
  14. 14. Towards More Comprehensive Care  Refugee patients transitioned into our student pool  For the 2016-17 academic year the CoD will provide, at no cost:  Pediatric treatment  Periodontal treatment (excl. surgery)  Restorative treatment (excl. esthetic, non-functional needs)  Created pool of volunteer interpreters from the wider University Community
  15. 15. Future Directions  College of Dentistry remains dental home for those in need  Formalized program manual developed  Outlined processes for staff, student and faculty
  16. 16. Future Directions  Evaluate clinic processes  Work to develop stronger relationship with settlement agencies  Extend care to other new Canadians  Develop more robust referral pathways (e.g., for specialist care)  Maintain clinic in response to need  Translate oral health materials into Arabic and other languages identified by settlement agencies
  17. 17. Thank You!!