口腔医疗服务利用水平的影响因素

口腔医疗服务利用水平的影响因素主要包括以下四方面:社会经济因素、口腔与全身健康因素、口腔健康相关意识因素和口腔健康相关行为因素.本文对以上四方面重要的影响因素进行综述,以期为提高人群口腔健康状况、促进人群积极、及时、便利地利用口腔医疗服务提供参考.     

江苏省居民口腔健康行为调查

目的:调查江苏省南京市城区、仪征化纤股份有限公司社区和句容农村35~44岁居民的口腔健康行为,并初步分析居民利用口腔卫生服务的因素。方法:采用问卷调查方法由经培训的问卷人员对502名南京等地的居民进行面对面访谈,收集城乡居民的口腔健康行为及相关影响因素。结果:城乡居民在每天刷牙次数、定期更换牙刷、定期洁牙等基本的口腔卫生保健措施方面存在高度显著性差异(P<0.01)。结论:城乡居民对口腔健康知识认识仍不足,牙科卫生服务利用较低,并多为口腔疾病症状所致,主动接受口腔预防措施少,口腔健康知识和行为亟待改进。     

乌鲁木齐机关干部口腔健康问卷调查分析

随着人民群众生活水平的提高,对健康的需求越来越迫切,保健的意识愈来愈高.本次调查主要了解机关工作人群口腔卫生保健的知识、态度和行为及其口腔保健服务利用情况,以评估口腔卫生需求.     

261例口腔科患者口腔保健行为的调查分析

目的 了解口腔科患者的口腔健康知识水平和行为的现状。方法 自设问卷对261例口腔内科就诊患者的口腔保健知识、行为、态度进行调查。结果 85．4％的人每天至少刷两次牙，32．6％的人选用含氟牙膏；多数患者的口腔保健行为和对口腔保健知识的知晓情况较好。结论 患者对牙科服务的利用与他们对口腔健康的重视程度有关。     

2005年广东省5岁人群口腔健康行为抽样调查报告

目的 了解广东省5岁城乡人群口腔健康行为现状,为广东省口腔卫生保健工作提供信息支持.方法 用多阶段分层等容量随机抽样的方法,抽取广东省5岁城乡常住人口360人,男女各半,城乡各半,按照《第三次全国口腔健康流行病学问卷调查方案》设计的5岁儿童家长标准问卷,对受检儿童父母进行现场询问.了解儿童口腔饮食行为、口腔卫生行为、利用口腔医疗服务行为.结果 43.06%的儿童曾有睡前吃甜食的行为.多数儿童刷牙频率为每天1～2次. 76.14%的儿童超过2年以上没有看过牙, 84.00%看牙儿童是因牙齿有问题需要治疗.结论 广东省儿童口腔健康行为尚不完善,有必要加强父母的口腔健康教育,建立正确儿童口腔健康行为.     

深圳市376名65~74岁老年人口腔健康行为抽样调查

目的:了解深圳市老年人群口腔卫生行为现状,为深圳市口腔卫生保健工作提供信息支持。方法:采用整群抽样法,抽取深圳市常住人口65~74岁老年组376人,按照《第三次全国口腔健康流行病学问卷调查方案》设计标准问卷,对行为生活方式、口腔卫生服务需求与利用、获取口腔保健知识的来源及途径等进行现场询问并记录。结果:深圳市65~74岁老年人每天刷牙2次及2次以上者占41%,老年人每天使用含氟牙膏占62%,牙线使用率极低。20.8%老年人近1年内有牙科就医行为,主要原因是急、慢性牙疼,定期口腔检查者极少。结论:深圳市老年人牙线使用率和定期口腔检查率很低,需加大口腔保健知识宣传,指导其建立良好的口腔卫生保健行为。     

重庆市主城区学龄前儿童患龋情况及口腔卫生服务需要、利用情况和影响因素的研究

目的 对重庆市主城区学龄前儿童口腔健康状况及其口腔卫生服务的需要和口腔卫生服务实际利用情况进行调查,分析其可能的影响因素,为重庆地区有针对性开展学龄前儿童口腔预防保健工作提供参考。方法 参考第四次全国口腔健康流行病学调查实施方案,采用整群随机抽样的方法抽取主城9区中的3区12个街道24所幼儿园共1 300名3~4岁儿童进行口腔检查,并根据安德森卫生服务利用行为模型设计调查问卷并发放给家长填写。对口腔卫生服务利用情况采用卡方检验和logistic逐步回归分析。结果 重庆市主城区学龄前儿童患龋率为55.4%,龋失补牙面数为6 696,龋面均为5.2,龋齿充填构成比为2.3%。有效问卷共1 173份,结果显示过去1年治疗性口腔就诊率为6.31%（74/1 173）,预防性口腔就诊率为22.93%（269/1 173）。照顾者的受教育程度、受口腔问题困扰、每天何时刷牙和过去1年牙疼史为口腔就诊率的影响因素。结论 重庆市学龄前儿童的口腔卫生服务需要仍普遍,口腔卫生服务利用不足,口腔医疗保健任务仍然十分艰巨,应进一步制定有针对性的口腔预防政策。     

云南人群口腔保健意识与对策

云南人群口腔保健意识与对策云南省牙病防治指导组（６５００２１）范群，林一南口腔健康教育可以激发人们利用各种健康信息，形成有益于口腔健康的习惯和行为，增进口腔健康，应贯穿于口腔健康的每一次服务中。１９９５年５月至７月，我省进行了口腔健康流行病学调查，在...     

预防与保健

影响家庭成员口腔卫生服务利用的多因素分析；德阳市成年人的口腔健康知识、态度及行为调查；北京市怀柔区儿童口腔健康状况的调查与分析一怀柔区调节水氟浓度预防龋齿可行性研究；脉冲Nd：YAG激光结合氟化钠对人牙本质、牙骨质人工龋的影响；3～5岁儿童牙菌斑液中氨基酸与龋易感性的关系；……[编者按]     

广西12岁儿童口腔健康行为抽样调查报告

目的 了解广西12岁儿童口腔健康行为、口腔卫生服务利用等情况。方法 采用多阶段分层等容量随机抽样的方法 抽取429名广西壮族自治区12岁城乡常住儿童进行集体自答式问卷调查。结果 广西93.71%(402/429)12岁学生每天刷牙,其中仅32.17%(138人)每天刷牙2次以上,城市刷牙情况好于农村(P<0.001)。调查前12个月口腔科就诊率为16.55%(71人),51.52%(221人)学生从没看过牙。口腔科就诊的主要原因是急、慢性牙疼。结论 广西大部分12岁儿童口腔健康行为仍较差,未能充分利用现有的口腔卫生资源,口腔健康教育有待加强。?     

The Relationship Between Dental Utilization and Preventive Participation Among a Well-elderly Sample

Previous studies have shown that dental utilization by older people is lower than for the general population. This study hypothesizes that an elder's tendency toward participating in preventive health activities may be an important factor in explaining the likelihood of accessing the dentist. Subjects included 1,911 older individuals who enrolled in the UCLA Medicare Screening and Health Promotion Trial. All were interviewed about their utilization of preventive health services and participation in preventive behaviors. A recent dental visit was positively associated with all sociodemographic variables examined except age and sex. It was also related to health status questions and utilization of the preventive health services and health behaviors studied. Logistic regression analysis showed that both summary preventive health behavior and preventive service utilization variables were important factors in explaining a recent dental visit (model chi-square/221.4, P=.001) along with income, not having a removable prosthesis, and perceiving the need for dental care. This study showed that dental utilization is related to older people's participation in other preventive activities. When in contact with older people, health care professionals should consider current oral and general preventive health status and encourage appropriate referral for preventive activities.     

A path analysis of the utilization of dental services

In this paper Andersen's model of health services utilization is applied to the use of dental visits. This analysis builds on previous work by including clinical oral health indicators rather than self-reports as measures of need by using a path model to analyze the dynamics of predisposing, enabling and need factors on dental utilization. The sample consisted of 287 volunteers who were employees of a university health center. The path analysis using ordinary least squares found that sex was the most important variable affecting use of services. Men tended to have higher number of visits due to higher need and women more visits regardless of need. A surprising result was that income had no significant effect on volume of dental visits, which contradicts much of the literature in the area. Finally, the analysis suggests that because of the nature of clinical oral health indicators cross-sectional analysis of dental service utilization may not be appropriate.     

Dental health services utilization and associated factors in children 6 to 12 years old in a low-income country

OBJECTIVE: To determine the factors associated with the dental health services utilization among children ages 6 to 12 in León, Nicaragua. MATERIAL AND METHODS: A cross-sectional study was carried out in 1,400 schoolchildren. Using a questionnaire, we determined information related to utilization and independent variables in the previous year. Oral health needs were established by means of a dental examination. To identify the independent variables associated with dental health services utilization, two types of multivariate regression models were used, according to the measurement scale of the outcome variable: a) frequency of utilization as (0) none, (1) one, and (2) two or more, analyzed with the ordered logistic regression and b) the type of service utilized as (0) none, (1) preventive services, (2) curative services, and (3) both services, analyzed with the multinomial logistic regression. RESULTS: The proportion of children who received at least one dental service in the 12 months prior to the study was 27.7 percent. The variables associated with utilization in the two models were older age, female sex, more frequent toothbrushing, positive attitude of the mother toward the child's oral health, higher socioeconomic level, and higher oral health needs. CONCLUSION: Various predisposing, enabling, and oral health needs variables were associated with higher dental health services utilization. As in prior reports elsewhere, these results from Nicaragua confirmed that utilization inequalities exist between socioeconomic groups. The multinomial logistic regression model evidenced the association of different variables depending on the type of service used.     

中国口腔医疗保险发展之分析

本文通过查阅大量文献,分析口腔疾病的特点、影响口腔服务利用的因素以及国内外口腔保险的现状,着重讨论了口腔医疗保险对改善口腔医疗服务利用率和促进人群口腔健康的积极作用,利用PEST分析法分析了在中国建立和完善口腔医疗保险的必要性和可行性,提出急需解决的核心问题和发展策略.只有发展口腔保险事业,提高人们对口腔健康的关注度以...     

Determinants of oral health care utilization among diverse groups of immigrants in New York City

BackgroundFew studies have examined utilization of oral health care services among immigrants. The authors examined the determinants of utilization of oral health care among a diverse group of immigrants in New York City.MethodsThe authors examined and interviewed 1,417 foreign-born people, aged 18 to 65 years, who were residents of New York City. They conducted examinations by using criteria established by the National Institute of Dental and Craniofacial Research, Bethesda, Md. The authors used unconditional logistic regression to estimate odds ratios (ORs) and 95 percent confidence intervals for having visited a dentist within the previous year for each of the independent variables.ResultsMore than 70 percent of the participants lacked dental insurance and only about 31 percent reported that they had visited a dentist within the previous year. Flossing (OR = 1.18), dental insurance (OR = 1.58), having a regular source of dental care (OR = 4.76) and more filled teeth (1.33) were independent predictors of utilization of services.ConclusionsHaving a regular source of dental care and having dental insurance are important predictors of immigrants' utilization of oral health care services in New York City.Clinical ImplicationsThe study results suggest the importance of establishing affordable, culturally appropriate, community-based oral health care services to improve the oral health of vulnerable populations.     

影响家庭成员口腔卫生服务利用的多因素分析

目的：建立就诊概率模型，测量我国家庭成员口腔卫生服务利用的影响因素，为建立合理有效的口腔保健服务体系提供依据。方法：根据我国不同地区经济（人均GDP)发展水平，采用分层抽样方法，进行现场入户家庭口腔健康问卷和口腔检查调查。采用Logistic回归，建立口腔卫生服务利用的就诊概率模型。结果：调查6个样本县(区)共587户1558人，将15岁以上家庭成员分别引入不同组变量后，Logistic回归分析的结果表明，3个不同模型的检验假设均具有统计学差异。结论：我国家庭成员的口腔卫生服务利用取决于多种因素，除自我口腔疾病判断外，医疗费用支付方式、家庭居住分区、有无龋病是影响中国居民牙科就诊概率的主要因素。     

Changes over 5 years in utilization of dental care by a Swedish age cohort

OBJECTIVE: The purpose of this study was to investigate the temporal development of the utilization of dental care, in relation to socio-economic factors and also considering perceived oral health, attitudes to dental care, dental anxiety, care organisation and changes in the way that dental care is paid for. A conflict model was used as a theoretical framework. METHODS: In 1992, a mail questionnaire was sent to all 50-year-old persons in two counties in Sweden, Orebro and Ostergotland, as part of a cross-sectional study. This study group numbered 8888 persons. In 1997, the same population was sent a new questionnaire. There were 5363 persons who completed the questionnaire in both 1992 and 1997. Changes in utilization of dental care were analysed. RESULTS: An increase in personal expenditure for care was obvious, 42% paid more in 1997 compared with 1992. In the study, 7% had prolonged their time since most recent visit and 12% had less frequent visits. In regression models, education, occupation, place of residence, country of birth, marital status, gender, dental anxiety, having poor perceived oral health and poor general health were associated with utilization. Care organisation factors showed there was a greater probability of having higher utilization and higher cost of care when private practitioners provided the care. CONCLUSION: Small changes in the utilization of dental care occurred during this study time. Inequality in utilization existed and socio-economic factors affected utilization as well as health perception and dental anxiety. Changes in the cost of care did not affect utilization appreciably, probably because of a selected population with high price elasticity. Having a private care provider compared with one in the public system affected the probability of having higher utilization and higher cost for care.     

Shifts between use and non-use of dental services among young Danish adults over a 3-year period

Utilization of dental services among three groups of young adults was studied longitudinally. Each year from age 16 to age 19, participants were defined as users or non-users of alternative dental programs. Dental programs were taking place with public dental health service clinics (n = 386), with private dental practitioners, free of charge (n = 161), and with private dental practitioners, partially reimbursed by health insurance (n = 261). The paper analyzes whether the pattern of utilization of the last two groups might be described by a Markovian model defining use or non-use of dental care each of 3 years as two mutually exclusive Markovian states. Contingency table analysis of the relationships of the utilization status and sex, social group, and delivery program showed that the utilization pattern could not be described by a Markovian model. Conversely, strong relationships between 1-yr user status and 3-yr user status was found. Implications in relation to the prevailing dental health care policy emphasizing regular dental care and continuity between child dental health care and young adult dental programs are discussed.     

Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan

Background  

HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors.     

Oral health‐care utilization in adults with disabilities in Belgium

Leroy R, Declerck D. Oral health‐care utilization in adults with disabilities in Belgium.
Eur J Oral Sci 2013; 121: 36–42. © 2012 Eur J Oral Sci Reports on oral health‐service utilization among individuals with disabilities are very sparse. Nevertheless, such data are a prerequisite for the provision of proper care and for the development of optimal reimbursement schemes and may ultimately lead to better access to care. The objective of the present study was to provide data on oral health‐care utilization in Belgian residents with disabilities and to compare these data with the utilization pattern of their peers without special needs. Data from the Permanent Sample of Socially Insured Persons, an anonymous representative sample of Belgian residents, were used. The database contained prospective data on oral and general health‐care utilization and socio‐demographic variables from 1,221 individuals with disabilities and from 131,877 individuals without disabilities, collected from 2002 to 2008. Overall, annual dental‐attendance rates were very low and in those who attended, professional debridements, a cornerstone in preventive oral health care, were infrequently recorded. In adults with disabilities, significantly fewer radiographs, restorations, and endodontic treatments were recorded, whereas significantly more emergency visits were charged. Further research is indicated to evaluate whether this outcome points to high unmet oral‐treatment needs.