北京市城乡居民口腔卫生服务利用与费用影响因素分析

目的：通过对北京市居民口腔卫生利用和费用的定量研究及影响因素分析，为控制口腔费用的增长和建立口腔医疗保险制度提供依据。方法：分层、整群、随机抽取城乡居民3395人进行调查，利用单变量Logistic 回归、方差分析和三部模型方法进行口腔卫生服务利用和费用的因素分析。结果：城区0－14岁儿童，享有保障制度和患病者的人群利用概率高，OR值分别为5．834、2．721、1．793，低收入者利用概率低，高收入者就诊费用高，儿童的就诊费用低较，保障制度对农村居民口腔卫生服务利用几乎没有影响。影响居民就诊的主要因素是年龄、职业，患病状况和收入的高低，一旦利用口腔卫生服务，影响就诊费用的主要是不同的病种。结论：年龄是影响居民需求的主要因素。收入对个人是否就诊的决定有显著作用，保障制度对城乡居民的服务利用呈现相反的趋势，无论城乡居民，一旦利用口腔卫生服务，口腔健康状况是影响利用频率和费用的重要因素。     

从我国口腔卫生服务需要需求和利用状况看我国目前口腔卫生工作中存在的问题和今后的工作思路

口腔健康是全身健康的重要组成部分,是世界卫生组织确定的健康的十大标准之一。我国居民口腔卫生需要巨大,但受多种原因影响,没有转化为口腔卫生需求,造成口腔卫生服务利用严重不足,既影响了居民口腔健康水平,同时也制约口腔卫生事业的发展。迫切需要加强政策倡导、加强健康促进、加大政府投入,多渠道筹措资金,提高群众支付能力,增加对口腔卫生服务的利用。此外,还应通过加大宣传,制定优惠政策等方式,促进口腔卫生服务的类型由有问题接受口腔卫生服务型向定期接受口腔卫生服务型转变。     

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。     

深圳市35~44岁人群口腔健康行为抽样调查分析

目的评估深圳市35~44岁人群口腔健康行为,为深圳市口腔卫生保健工作提供信息支持。 方法采用多阶段随机抽样方法,抽取深圳市35~44岁常住居民共1230人,按照《第三次全国口腔健康流行病学问卷调查方案》设计口腔健康调查问卷,就行为生活方式、口腔卫生服务的使用及获取口腔保健知识的来源及途径等进行调查分析,回收有效问卷1224份。 结果深圳市35~44岁人群中,91.7%每天刷牙,55.6%每天刷牙2次及2次以上;72.1%的人使用含氟牙膏刷牙,牙线使用率极低;近1年内口腔科就诊率15.9%,90%以上是因为急、慢性牙疼和其他口腔问题,进行定期口腔检查的人口比率极少。电视/广播仍为获取口腔卫生知识的最主要途径,而其它途径少。 结论提高人群口腔预防保健意识、改变行为习惯,丰富口腔健康教育内容及形式仍然是深圳市今后口腔预防保健工作的重点。     

大学新生口腔健康知识和健康行为抽样调查报告

目的　调查大学新生口腔健康知识和健康行为。方法　采用全国口腔健康流行病学调查方案统一问卷, 对四川大学1 035名大学新生进行口腔健康知识和健康行为问卷调查。结果　(1)口腔疾病就医行为:1 035名大 学新生中仅13·1%的学生定期接受口腔健康检查;(2)口腔卫生措施:每天刷牙两次的占74·4%,刷牙时间达到 3 min以上的仅7·7%,坚持使用含氟牙膏的16·6%,使用过牙线的人仅6%;(3)饮食习惯:51·9%的学生不常吃零 食,94·7%的学生不吸烟;(4)龋齿与牙周疾病的防治知识及口腔保健知识测试结果普遍较差。结论　大学新生对 口腔卫生知识认识有限,采取的口腔卫生措施不够认真彻底。     

口腔卫生健康指导对孕期妇女口腔健康的促进作用

目的:观察口腔卫生健康指导对孕期妇女口腔健康的促进作用。方法:从2010—2011年在海珠区妇幼保健院进行产前检查的初孕妇进行初筛后,从中选择780名,经基线检查并对相关口腔疾病治疗后,分为实验组(350名)和对照组(430名),实验组由口腔医师定期进行口腔卫生指导,对照组不进行口腔卫生指导。6个月后口腔检查,评价口腔卫生健康指导对孕期妇女口腔健康的作用。结果:经过口腔卫生健康指导后,实验组口腔卫生状况优于对照组(P<0.05),牙龈炎、龋病发病率均低于对照组(P<0.05)。结论:孕妇口腔卫生健康指导对其口腔健康具有促进作用,建议纳入社区卫生服务范围。     

口腔健康教育前后小学生口腔健康知识行为变化调查

目的　探讨口腔健康教育对儿童口腔健康知识和行为的影响。方法　自行设计调查表 ,采用重复测量的方法 ,调查口腔健康教育前后儿童口腔健康知识和行为情况。结果　口腔健康教育可显著提高儿童口腔健康知识 ,对口腔健康行为有一定的作用 ,口腔健康行为的改变与父母职业有关。结论　口腔健康教育对儿童口腔健康知识和口腔健康行为有积极作用 ,应在小学生中开展常规的口腔卫生教育课     

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.     

深圳市社区健康服务中心口腔科现状调查

目的调查分析深圳市社区健康服务中心口腔科现状,为进一步合理规划深圳市的口腔卫生防治资源提供参考。方法采用问卷调查方式,对深圳市所有社区健康服务中心口腔医师、口腔护士及口腔治疗设备配置情况以及居民对社区口腔卫生服务的需求情况进行调查。结果深圳市共有社区健康服务中心559问,其中有开设口腔门诊的92问,仅占16．45％,其中67％集中在中心片区。共有口腔综合治疗椅161台,口腔专业人员182人,医生护士之比为4．2：1。社区居民需求方面：74．5％的社区居民认为到社区口腔中心就诊方便,70．4％的认为有必要在社区增设口腔门诊,受调查的居民中21。1％的每年进行口腔检查,8．5％的每年进行洁牙。结论深圳市社区健康服务中心口腔科设置比例偏低,分布不合理,口腔卫生服务不能满足社区居民需求。政府部门应进一步加强口腔专业防治人员引进,并在人、财、物等方面给予大力支持。居民口腔保健意识有待加强。     

武汉市东西湖区5岁儿童口腔健康行为调查

目的:了解东西湖区5岁儿童的基本口腔健康行为及其家长的儿童口腔卫生知识水平,为东西湖区儿童口腔卫生保健工作提供信息支持。方法:按照第三次全国口腔健康流行病学调查方案设计的5岁儿童家长问卷,对东西湖区8所幼儿园529名5岁儿童家长进行问卷调查,了解儿童饮食行为,口腔卫生行为、利用口腔医疗行为,家长口腔保健知识知晓情况。结果:30%的儿童经常有睡前进食甜食的习惯。5%的儿童在3岁前开始刷牙,每日刷牙2次者仅占10%。有5%的儿童使用含氟牙膏刷牙。在过去1年中,90%的儿童没看过牙医。结论:东西湖区5岁儿童口腔健康行为低于全国平均水平,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,建立正确的儿童口腔健康行为。     

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。     

Oral health status of older rural adults in the United States

BACKGROUND: Little is known about the oral health care of older rural residents. The authors describe oral health indicators for the older adult population by place of residence in the United States. METHODS: The authors analyzed data from the Third National Health and Nutrition Examination Survey and the 1995, 1997 and 1998 National Health Interview Surveys. Oral health indicators included perceived oral health (self-reported dental status and unmet dental needs) and dental status (untreated caries; decayed, missing and filled permanent teeth, or DMFT; and edentulism). Dental care utilization and access were measured by number of dental visits, frequency of dental visits and dental insurance status. RESULTS: Older rural adults were more likely than their urban counterparts to be uninsured for dental care (72.1 percent versus 66.1 percent, respectively) and were less likely to report dental visits in the past year (46.9 percent versus 58.4 percent, respectively). A higher proportion of rural residents than urban residents were edentulous (36.7 percent versus 28.2 percent, respectively) and reported poor dental status (50.7 percent versus 42.2 percent, respectively). There were no differences in unmet dental needs, percentage of people with untreated caries or in mean DMFT by place of residence. CONCLUSIONS: Older rural residents inadequately utilize dental care and have less favorable oral health indicators than do older urban residents. CLINICAL IMPLICATIONS: This article shows the need for more dental practitioners in rural areas. With the low density of dentists per person and the high need for care, rural America offers an excellent opportunity for oral health professionals to provide much needed services.     

Dental utilization for medicaid‐enrolled adults with developmental disabilities in Iowa residential care facilities

The goal of this study was to evaluate the dental utilization of Medicaid‐enrolled adults in Iowa residential care facilities (n = 1423). Medicaid enrollment and claims files for 2003 were used, as well as information from the Iowa Department of Inspections and Appeals. Dental utilization was defined as having any dental visit during 2003. Of the residents, 74.1% utilized at least one dental service in 2003. Residents in facilities that were part of smaller organizations, and younger residents, were more likely to have had a dental visit. Of those with a visit, over 80% received a preventive service but this declined with age. Despite additional barriers, dental utilization was generally good for Medicaid‐enrolled residents of residential care facilities in Iowa. Residents in smaller facilities of smaller organizations received more personalized care. Older residents were less likely to have a parent involved, were more likely to be edentulous, and sought care less frequently.     

Trends in use of dental care provider types and services in the United States in 2000-2016: Rural-urban comparisons

BackgroundThe authors conducted a study to assess recent trends in dental care provider mix (type of dental professionals visited) and service mix (types of dental procedures) use in the United States and to assess rural-urban disparities.MethodsData were from the 2000 through 2016 Medical Expenditure Panel Survey. The sample was limited to respondents who reported at least 1 dental visit to a dental professional in the survey year (N = 138,734 adults ≥ 18 years). The authors estimated rates of visiting 3 dental professionals and undergoing 5 dental procedures and assessed the time trends by rural-urban residence and variation within rural areas. Multiple logistic regression was used to assess the association between rural and urban residence and service and provider mix.ResultsA decreasing trend was observed in visiting a general dentist, and an increasing trend was observed in visiting a dental hygienist for both urban and rural residents (trend P values < .001). An increasing trend in having preventive procedures and a decreasing trend in having restorative and oral surgery procedures were observed only for urban residents (trend P values < .001). The combined data for 2000 through 2016 showed that rural residents were less likely to receive diagnostic services (adjusted odds ratio [AOR], 0.82; 95% confidence interval [CI], 0.72 to 0.93) and preventive services (AOR, 0.87; 95% CI, 0.78 to 0.96), and more likely to receive restorative (AOR, 1.11; 95% CI, 1.02 to 1.21) and oral surgery services (AOR, 1.23; 95% CI, 1.11 to 1.37).ConclusionsAlthough preventive dental services increased while surgical procedures decreased from 2000 through 2016 in the United States, significant oral health care disparities were found between rural and urban residents.Practical ImplicationsThese results of this study may help inform future initiatives to improve oral health in underserved communities. By understanding the types of providers visited and dental services received, US dentists will be better positioned to meet their patients’ oral health needs.     

Utilization of dental services in Southern China.

A population's utilization of dental services is an important parameter in oral health care planning, which has rarely been studied in China. The objectives of this report were to describe the dental service utilization pattern of middle-aged and elderly Chinese and to analyze the influence of selected variables on the use of dental services. A Guangdong Province population of 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds recruited from urban and rural communities was interviewed in their local dialect. It was found that 23% of the middle-aged and 24% of the elderly subjects had visited a dentist within the preceding year. The two most commonly cited reasons for not having seen a dentist for at least 3 years were: no perceived need, and no serious dental problems. Among subjects who had visited a dentist within 3 years, the 3 most commonly received treatments were: fillings, extractions, and dental prostheses. Furthermore, a logistic regression analysis showed that women, subjects who lived in urban areas, were better educated, were wealthier, and had better oral health knowledge were more likely to be a recent dental service user. In conclusion, dental service utilization among the adult Southern Chinese was found to be low, problem-driven, and influenced by some socio-economic factors.     

北京市城乡居民口腔医疗服务利用与费用分析

目的 对北京市城乡居民口腔医疗服务利用和费用进行定量研究，为口腔医疗保障制度的制定提供依据。方法 采用分层、整群、随机抽样方法抽取城区人口1517人，农村人口1878人，利用人户调查方式进行口腔医疗服务利用和费用的调查。结果 城乡居民口腔疾病就诊率均处于较低水平，但次均费用较高。农村居民就诊率为城区居民的1／3，次均费用约为城区居民的1／2。农村居民口腔费用支出占年收入的2．07％，城区居民为1．77％。不同人口、社会经济学背景的人群费用支出差异有显著性。结论 北京市居民的口腔医疗费用水平较高，在收入中占相当比重，并且农村居民的费用负担要重于城区居民。本研究中所调查的费用水平可为北京市口腔医疗保险覆盖提供一定参考依据。     

江西省3~5岁儿童对口腔卫生服务需求与就诊利用的现状及对策

目的 了解江西省3~5岁儿童口腔卫生服务需求与就诊利用现状,为制定相关的口腔保健政策,提高口腔卫生服务利用及就诊率,优化口腔人力及服务资源提供数据支持。方法 采用分层整群抽样法随机抽取2 880名儿童进行口腔检查,并对家长进行问卷调查。检查方法和诊断标准参照第四次全国口腔健康流行病学调查方案的规定。用Excel 2007和SPSS 19.0软件对数据进行处理,主要方法为统计描述,卡方检验与Logistic回归分析。结果 2 880例3~5岁儿童乳牙患龋率为49.13%（1 415/2 880）,53.37%（1 537/2 880）的儿童有口腔卫生服务需求,低年龄儿童家长对孩子的口腔状况评价好于高年龄儿童（P<0.05）,城市儿童的评价好于农村儿童（P<0.05）。全部调查对象的口腔就诊率为12.33%（355/2 880）;有口腔疾病儿童就诊率为17.31%（266/1 537）,未就诊原因的前3位依次为：“认为孩子的牙没问题”、“以为牙坏得不严重”、“认为乳牙会替换不需要看”。影响就诊的因素：女性较男性就诊率低（OR=0.499,95%CI：0.411~0.606）,农村较城市就诊率低（OR=0.428,95%CI：0.353~0.519）,口腔健康状况差、口腔知识得分高的对象其口腔就诊率高。结论 江西省3~5岁儿童患龋率低于全国水平,有口腔卫生服务需要而主动寻求就诊服务的比例较低,就诊目的以治疗为主,预防咨询较少。相关部门应加强口腔健康教育宣传并建议纳入幼师培训计划,以提高居民就诊意识和儿童口腔健康水平。     

Factors influencing use of dental services in rural and urban communities: considerations for practitioners in underserved areas

Individuals' utilization of dental services depends upon an array of factors, including access to care, financial restrictions, attitudes toward dental care, and dental fear. These factors, in turn, may vary across geographic locations and demographic groups. The goals of this study were to assess the use of dental services in both rural and urban areas of Kentucky and to examine challenges facing practitioners in rural areas. Individuals sampled from a rural population and patients in rural and urban dental clinics completed questionnaires about use of dental services, self-rated dental health, and dental fear. While these variables were strongly interrelated, differences emerged across locations. Patients in the urban area reported having more dental insurance but not better dental health. Patients in more rural areas reported seeking more emergency dental treatment but not more dental fear. While these factors are important considerations across locations, dental practitioners in rural areas in particular should be aware of barriers to dental care facing individuals in these areas. They have unique opportunities to provide education to their patients regarding the importance of dental care and the role of oral health in overall physical health.     

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。     

Influence of patient,visit, and oral health factors on dental service provision

OBJECTIVES: Service provision should reflect the oral health of the patient. However, patient and visit factors may influence service patterns and the appropriateness of care delivered. The aim of this study was to examine factors associated with variation in dental services and to assess whether variation by patient and visit characteristics persisted after controlling for oral health status. METHODS: A random sample of Australian dentists was surveyed during 1997-98 (response rate = 60.3%). Private general practitioners (n = 345) provided data on service provision, as well as patient, visit and oral health variables from a log of a typical clinical day (n = 4,115 patients). Multivariate Poisson regression models were run for eight service areas (e.g., diagnostic, preventive, and restorative). RESULTS: Significant effects (P < .05) were observed for oral health factors in all eight models, visit factors in all eight models, patient demographics in four models, dental knowledge/behavior in one model, and area-based socioeconomic status in one model. CONCLUSIONS: After controlling for oral health, visit characteristics persisted as significant predictors of services, with nonemergency visits, insurance, and capital city location associated with more favorable service mix patterns. Higher socioeconomic status areas and payment scale ratings also were associated with a better service pattern in particular service areas. These findings show that a wide range of factors, in addition to oral health, contribute to variation in service provision.