Stakeholders’ Perspectives on Quality Measurement of Oral Health Care in the Netherlands: A Qualitative Study

Objective: This study aimed to identify which barriers and facilitators exist and can be expected when measuring quality of oral health care according to different stakeholders in the Netherlands. Methods: A total of 36 semistructured interviews were conducted with dentists, patients, universities and knowledge institutes, health insurance companies, professional dental associations, and governmental health organisations. Using qualitative content analysis, barriers and facilitators were classified according to the frameworks of Grol and Cabana. Results: In total 70 barrier and 53 facilitating factors were identified in the 5 domains of the frameworks. Various stakeholders found quality measurement challenging because the quality of oral health care is difficult to define with a lack of consensus on what constitutes quality of oral health care. Patients mentioned that, for them, quality of oral health care is difficult to assess. Dentists experienced a fear of being monitored and were apprehensive of the administrative burden of quality measurement. On an organisational level, the isolation of dentistry from the medical field was mentioned as a barrier. Facilitating factors were discussing quality in a trusted environment, and developing more clinical practice guidelines, which include meaningful quality measures. Discussion: This study identified barriers and facilitators for measuring quality of oral health care in the Netherlands. Findings signal the importance of achieving consensus on the definition of quality of oral health care. Further strategy discussions about how quality of oral health care can be made insightful in a way acceptable to all stakeholders are needed to make progressions in quality improvement.