Open Access Research article

Effectiveness of a quality management program in dental care practices

Katja Goetz1*, Stephen M Campbell12, Björn Broge3, Marc Brodowski3, Michel Wensing14 and Joachim Szecsenyi13

Author Affiliations

1 Department of General Practice and Health Services Research, University of Heidelberg, Vosstr. 2, Building 37, Heidelberg D-69115, Germany

2 Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK

3 AQUA-Institute for Applied Quality Improvement and Research in Health Care, Goettingen, Germany

4 Scientific Institute for Quality of Health Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

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BMC Oral Health 2014, 14:41  doi:10.1186/1472-6831-14-41

Published: 28 April 2014



Structured quality management is an important aspect for improving patient dental care outcomes, but reliable evidence to validate effects is lacking. We aimed to examine the effectiveness of a quality management program in primary dental care settings in Germany.


This was an exploratory study with a before-after-design. 45 dental care practices that had completed the European Practice Assessment (EPA) accreditation scheme twice (intervention group) were selected for the study. The mean interval between the before and after assessment was 36 months. The comparison group comprised of 56 dental practices that had undergone their first assessment simultaneously with follow-up assessment in the intervention group. Aggregated scores for five EPA domains: ‘infrastructure’, ‘information’, ‘finance’, ‘quality and safety’ and ‘people’ were calculated.


In the intervention group, small non-significant improvements were found in the EPA domains. At follow-up, the intervention group had higher scores on EPA domains as compared with the comparison group (range of differences was 4.2 to 10.8 across domains). These differences were all significant in regression analyses, which controlled for relevant dental practice characteristics.


Dental care practices that implemented a quality management program had better organizational quality in contrast to a comparison group. This may reflect both improvements in the intervention group and a selection effect of dental practices volunteering for the first round of EPA practice assessment.

Dental care; Oral health care; Quality of care; Quality improvement; Quality management