Periodic Reporting for period 1 - PRUDENT (Prioritization, incentives and Resource use for sUstainable DENTistry)
Reporting period: 2023-01-01 to 2024-06-30
Many EU citizens do not have access to essential oral health care without financial hardship. This causes detrimental impacts for the individual citizen, while increasing costs and wasting resources on the macro level. To address this complex systems problem, PRUDENT will leverage cutting-edge health economics and implementation science methods to convert novel evidence on oral health financing into meaningful improvements of oral care. The overall aim of PRUDENT is to develop an oral health financing model. PRUDENT has three overarching objectives:
Objective 1-Indicators & monitoring framework:
Develop a harmonized core set of oral health system indicators, implement in a novel EU wide monitoring system (WP2).
Objective 2–Optimization of financing mechanisms:
Identify optimization strategies for oral care financing. Real-world and lab experiments on provider payment and oral care insurance coverage, needs-adaptive resource planning, regulatory learning and digital decision aid tools will be leveraged (WP3,WP4).
Objective 3–Implementation strategies:
Harness innovative knowledge transfer strategies for co-development and co-production of sustainable implementation strategies (WP5,WP6,WP7).
Objective 1-Indicators & monitoring framework:
Develop a harmonized core set of oral health system indicators, implement in a novel EU wide monitoring system (WP2).
Objective 2–Optimization of financing mechanisms:
Identify optimization strategies for oral care financing. Real-world and lab experiments on provider payment and oral care insurance coverage, needs-adaptive resource planning, regulatory learning and digital decision aid tools will be leveraged (WP3,WP4).
Objective 3–Implementation strategies:
Harness innovative knowledge transfer strategies for co-development and co-production of sustainable implementation strategies (WP5,WP6,WP7).
The tasks which have finished or are in progress are listed below by workpackage
Work package 1 - Project coordination and management
Key tasks performed and main achievement:
T1.1: Communication: Teams and email list established
T1.2: Meetings: Regular meetings of Project management team (weekly), General Assembly (annual), Executive Board (monthly), SAB (annual) established.
T1.3: Controlling of the technical and financial status: reporting mechanism in place.
T1.4: Decision making structures: DESCA consortium agreement in place and followed.
T1.5: Overview and supervision of legal/contractual issue: started and progressing well.
T1.6: Assurance of compliance with ethics and data protection regulations: ELAB established and issues reviewed at EB/GA meetings.
T1.7: Innovation Management: started and progressing well.
Work package 2 - situation analysis, indicators, monitoring
Key tasks performed and main achievement:
T2.1: Ethics approval and detailed study protocol: accomplished.
T2.2: Consenting on essential oral health care benefit basket: consensus on features of benefit basked achieved.
T2.3: Situation analysis and typology of oral health financing mechanisms in Europe: accomplished
T2.4: Deliberative development of a harmonized set of performance indicators of oral health financing and oral health care: potential indicators compiled and currently being tested.
T2.5: EU-wide monitoring framework for oral systems performance: started and progressing well
Work package 3 - Behavioural economics Lab
Key tasks performed and main achievement:
T3.1: Ethics approval and study protocol: accomplished.
T3.2: Eliciting how citizens prioritize oral health care services using survey-based experiments: survey design complete and online panel provider chosen.
T3.4: T3.4. Eliciting dentists’ preferred supply of oral health care services using survey-based experiments: Piloting of Danish survey underway and design of English survey ongoing.
Work package 4 - Experimental implementation
Key tasks performed and main achievement:
T4.1: Ethics approval and detailed study protocol: accomplished
T4.2: Practice-based study on risk-adjusted capitation and performance-tied bonus payments: study design optimised, practices/patients recruited and study continuing as planned.
T4.3: Quasi-experimental impact evaluation of a major reform to achieve UHC for oral care: access to dataset secured. Preliminary analysis underway.
T4.5: Identifying actionable regulatory tools to improve oral care financing: questionnaires being designed.
Work package 5 - Needs-based resource planning
Key tasks performed and main achievement:
T5.1: Ethics approval and detailed study protocol: accomplished
T5.2: Evidence synthesis on key relevant determinants of oral care needs: literature, scoping and systematic reviews underway. Survey currently live.
T5.3: System dynamics model for needs-adaptive & cost-efficient resource/workforce planning: model developed and being adapted for individual countries.
Work package 6 - Deliberative processes
Key tasks performed and main achievement:
T6.1: Protocol development and ethical approval: Discussions are ongoing between partners and stakeholders design of the studies.
Work package 7 - Knowledge transfer
Key tasks performed and main achievement:
T7.1: Set up, update and implement DEC strategy: DEC plan developed and under continuous review
T7.2: Production & distribution of communication tools & promotional material: Website and social media established with regular updates.
T7.3: Disseminations and communication activities: Publications and presentations already completed and plans in place.
T7.4: Management and Exploitation Planning: started and progressing well.
Work package 1 - Project coordination and management
Key tasks performed and main achievement:
T1.1: Communication: Teams and email list established
T1.2: Meetings: Regular meetings of Project management team (weekly), General Assembly (annual), Executive Board (monthly), SAB (annual) established.
T1.3: Controlling of the technical and financial status: reporting mechanism in place.
T1.4: Decision making structures: DESCA consortium agreement in place and followed.
T1.5: Overview and supervision of legal/contractual issue: started and progressing well.
T1.6: Assurance of compliance with ethics and data protection regulations: ELAB established and issues reviewed at EB/GA meetings.
T1.7: Innovation Management: started and progressing well.
Work package 2 - situation analysis, indicators, monitoring
Key tasks performed and main achievement:
T2.1: Ethics approval and detailed study protocol: accomplished.
T2.2: Consenting on essential oral health care benefit basket: consensus on features of benefit basked achieved.
T2.3: Situation analysis and typology of oral health financing mechanisms in Europe: accomplished
T2.4: Deliberative development of a harmonized set of performance indicators of oral health financing and oral health care: potential indicators compiled and currently being tested.
T2.5: EU-wide monitoring framework for oral systems performance: started and progressing well
Work package 3 - Behavioural economics Lab
Key tasks performed and main achievement:
T3.1: Ethics approval and study protocol: accomplished.
T3.2: Eliciting how citizens prioritize oral health care services using survey-based experiments: survey design complete and online panel provider chosen.
T3.4: T3.4. Eliciting dentists’ preferred supply of oral health care services using survey-based experiments: Piloting of Danish survey underway and design of English survey ongoing.
Work package 4 - Experimental implementation
Key tasks performed and main achievement:
T4.1: Ethics approval and detailed study protocol: accomplished
T4.2: Practice-based study on risk-adjusted capitation and performance-tied bonus payments: study design optimised, practices/patients recruited and study continuing as planned.
T4.3: Quasi-experimental impact evaluation of a major reform to achieve UHC for oral care: access to dataset secured. Preliminary analysis underway.
T4.5: Identifying actionable regulatory tools to improve oral care financing: questionnaires being designed.
Work package 5 - Needs-based resource planning
Key tasks performed and main achievement:
T5.1: Ethics approval and detailed study protocol: accomplished
T5.2: Evidence synthesis on key relevant determinants of oral care needs: literature, scoping and systematic reviews underway. Survey currently live.
T5.3: System dynamics model for needs-adaptive & cost-efficient resource/workforce planning: model developed and being adapted for individual countries.
Work package 6 - Deliberative processes
Key tasks performed and main achievement:
T6.1: Protocol development and ethical approval: Discussions are ongoing between partners and stakeholders design of the studies.
Work package 7 - Knowledge transfer
Key tasks performed and main achievement:
T7.1: Set up, update and implement DEC strategy: DEC plan developed and under continuous review
T7.2: Production & distribution of communication tools & promotional material: Website and social media established with regular updates.
T7.3: Disseminations and communication activities: Publications and presentations already completed and plans in place.
T7.4: Management and Exploitation Planning: started and progressing well.
Expected results:
Work is ongoing and so results/potential impacts are preliminary at this stage. Nevertheless, the progress achieved so far indicates that the project will deliver several results beyond the state of the art. These will be synthesized in the PRUDENT Financing Companion and include:
1. Core set of indicators for oral care systems performance monitoring: given the substantial variety in oral health systems identified so far, these indicators will be instrumental in facilitating transformative change in oral health systems in Europe.
2. Know-how for tailoring essential packages of oral care & insurance coverage to citizen preferences: given the absence of previous such work, this will be instrumental for transformative positive change.
3. Know-how for designing incentives according tot provider behaviours: this will be instrumental for transformative positive change towards better access to preventive-oriented oral healthcare.
4. Know-how for implementation of oral care financing reform & innovations: this will be instrumental for implementation of new financing mechanisms.
5. Know-how for needs-adaptive oral health resource & workforce planning: this will be instrumental for operationalization of appropriate human resources for oral health.
6. Know-how for leveraging deliberative processes for better priority setting: this will be instrumental to inform decision-making processes around better use of resources.
7. Implementation support tools:
- Policy briefs
- Decision aids
- Regulatory Sandbox
To further enhance further uptake and success, the consortium will seek support from the European IP Helpdesk, request a Horizon IP Scan, and leverage the features provided by the Horizon Results Booster.
Work is ongoing and so results/potential impacts are preliminary at this stage. Nevertheless, the progress achieved so far indicates that the project will deliver several results beyond the state of the art. These will be synthesized in the PRUDENT Financing Companion and include:
1. Core set of indicators for oral care systems performance monitoring: given the substantial variety in oral health systems identified so far, these indicators will be instrumental in facilitating transformative change in oral health systems in Europe.
2. Know-how for tailoring essential packages of oral care & insurance coverage to citizen preferences: given the absence of previous such work, this will be instrumental for transformative positive change.
3. Know-how for designing incentives according tot provider behaviours: this will be instrumental for transformative positive change towards better access to preventive-oriented oral healthcare.
4. Know-how for implementation of oral care financing reform & innovations: this will be instrumental for implementation of new financing mechanisms.
5. Know-how for needs-adaptive oral health resource & workforce planning: this will be instrumental for operationalization of appropriate human resources for oral health.
6. Know-how for leveraging deliberative processes for better priority setting: this will be instrumental to inform decision-making processes around better use of resources.
7. Implementation support tools:
- Policy briefs
- Decision aids
- Regulatory Sandbox
To further enhance further uptake and success, the consortium will seek support from the European IP Helpdesk, request a Horizon IP Scan, and leverage the features provided by the Horizon Results Booster.