我国家庭人口口腔医疗需要调查报告

目的了解我国家庭人口口腔医疗需要情况,探索口腔疾病发病规律和口腔医疗保健现状。方法将口腔医疗需要情况按需要医疗的程度分为四类,分别进行口腔健康检查、填写记录。结果调查6个样本县和(或)区共587户1 558人,其中共有48.62%需要按期口腔医疗,有45.63%需要及早口腔医疗,有2.13%需要紧急口腔医疗,有28.61%不需要任何口腔医疗。结论我国家庭人口的口腔医疗需要十分普遍,口腔医疗任务也十分的艰巨,加强口腔疾病预防工作、建立口腔疾病防治程序等十分必要。     

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。     

江西省35～44岁人群对口腔卫生服务的需求和利用

目的调查江西省35～44岁人群口腔健康状况及其对口腔卫生服务的需求和利用,为有效开展口腔健康教育提供基线资料。方法采用多阶段分层等容量随机抽样方法,对江西省35～44岁年龄组共792人进行口腔临床检查和问卷调查。结果35～44岁人群中龋齿患病率59.4%,龋齿充填率12.1%,牙龈出血、牙结石、牙周袋、附着丧失≥4 mm检出率分别为98.7%、99.6%、76.0%、84.2%;认识水平和经济因素致使35～44岁人群对口腔卫生服务的需求和利用较低。结论应加强对35～44岁人群的口腔健康教育,提高其口腔保健意识,同时,应健全和完善口腔卫生服务系统,促使35～44岁人群对口腔卫生服务的需求和利用。     

都江堰市地震灾区人群口腔医疗需要现况调查

目的:了解我国地震灾区人群口腔医疗需求现况.探索地震灾后口腔疾病发病规律和开展口腔医疗保健对策,为今后地震灾区口腔卫生服务的决策提供信息和依据.方法:以WHO口腔健康调查基本方法为标准,采用随机整群抽样调查方法.将口腔医疗需求情况按需要医疗的程度分为4类,分别进行口腔健康问卷和检查.利用FoxPro6.0软件建立数据库,SPsS11.5软件包进行统计学分析.结果:完成都江堰市灾区15个平板房社区共计970人的口腔健康调查,共有81.3%人次需要定期进行口腔医疗,62.8%人次需要及早口腔医疗,6.1%人次需要口腔医疗急诊,仅有3.8%人次不需要任何口腔医疗.结论:地震灾区人群的口腔医疗需求十分普遍,口腔医疗任务也十分艰巨,应该重视地震灾区人群口腔健康问题,加强口腔疾病预防控制工作.     

西藏山南地区藏族高中毕业生口腔医疗需求调查

目的：调查西藏山南地区藏族高中毕业生口腔健康状况,了解学生口腔医疗需求情况。方法：以WHO口腔健康调查基本方法为标准,对西藏山南地区高中毕业生进行口腔健康调查,将口腔医疗需求情况分为四类,利用SPSS17．0软件进行统计学分析。结果：完成1907名学生的口腔健康调查,共有53．33％的人需定期进行口腔医疗,41．48％的人需及早口腔医疗,有2．52％的人需口腔医疗急诊,仅有28．37％的人不需口腔医疗。近1年内曾经到医院（或诊所）看过牙齿者仅有65人（3．41％）。结论：西藏藏族高中毕业生人群的口腔医疗需求十分普遍,应该重视该地区人群口腔健康问题,加强口腔疾病预防控制工作,改善当地的口腔医疗条件。     

口腔卫生师的职业与职责

口腔卫生师(hygienist)是口腔医疗卫生保健的特殊职业,是口腔卫生保健的专业人才,是口腔疾病预防的主力,作为口腔医学的重要组成部分,组成了口腔医疗的基本结构单元.口腔卫生师有明确的职业特征和社会属性,在大众的口腔医疗卫生保健中发挥独特的重要作用.口腔卫生师通过口腔卫生宣教,提高大众的口腔健康素质和修养;通过口腔照...     

中国居民口腔健康指南

为更好贯彻落实《卫生部办公厅关于加强口腔卫生工作的通知》（卫办疾控发2007]196号）精神,规范医疗卫生机构口腔健康教育工作,帮助我国群众掌握正确的口腔卫生保健知识,养成良好的口腔卫生习惯,卫生部组织制定了《中国居民口腔健康指南》。并于2009年7月7日印发《卫生部办公厅关于印发〈中国居民12I腔健康指南〉的通知》（卫办疾控发2009]141号）给各省、自治区、直辖市卫生厅局,新疆生产建设兵团卫生局,中国疾病预防控制中心,要求各地遵照执行。鉴于该指南的权威性和实用性,本刊现转载全文,以飨读者。     

成都市外国人口腔卫生服务利用的影响因素研究

目的 调查中国成都市外国人的口腔卫生服务利用情况及其影响因素,为口腔卫生从业者对口腔卫生服务的国际化发展进行探索,为卫生政策制定者制定移民口腔健康政策提供建议。方法 参照世界卫生组织制定的《成人口腔健康问卷》,结合安德森卫生服务利用模型设计问卷。问卷内容包括口腔健康情况、口腔保健意识、口腔健康保障和基本信息4个部分。采用方便抽样方法选择调查对象。调查结果使用SPSS 20.0统计软件分析,采用Binary Logistic回归和分层分析方法进行统计学分析。结果 共有来自75个国家的654名调查对象完成调查,结果显示有102（15.6%）名外国人在成都曾经遇到过口腔问题却没有就诊。Binary Logistic回归分析显示,女性、长时间在成都居住、过去1年内出现过口腔健康问题、有使用牙线习惯、和家人一起居住在成都者遇到口腔问题或定期口腔体检时,更倾向于到本地口腔科就诊。通过ROC曲线分析,居住在成都10.5个月是外国人选择在成都就诊的临界值。结论 卫生政策制定者可以根据不同居住时间的外国人制定不同的口腔急诊或平诊指南,创造出更方便外国人在成都因口腔问题就诊的环境,以促进外国人在成都的口腔卫生服务利用。     

北京市城乡居民口腔卫生服务利用与费用模型的研究

目的 建立北京市城乡居民口腔卫生服务利用预测模型，进行精确性研究，为开展口腔医疗保险提供依据。方法 采用分层、整群、随机抽样方法，抽取城乡居民共3395人进行调查，利用Logistic回归拟合就诊概率模型；利用对数线性回归拟合利用者的就诊频率和费用模型。利用平均预测偏差、预测残差均方和相对预测偏差进行模型预测效果评价。结果 城乡居民口腔卫生服务利用三部模型拟合较好，就诊概率模型的调整决定系数较高．城乡分别为0．621和0．642，而就诊频率和费用的调整决定系数较低。就诊概率模型预测精确度分别为城区83．7％，农村89．6％。就诊频率和费用相对预测偏差为8．85％～14．10％。结论 分解模型法是建立口腔卫生服务利用预测模型的较好方法，预测准确性较高，通过对数转换可改善资料的偏态性。预测模型可用来进行影响因素分析和保险基金与保险因子的测算。     

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。     

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。     

Equality in satisfaction, perceived need, and utilization of dental care in a 50-year old Swedish population

Abstract Satisfaction with dental care, perceived need for dental care, and dental care utilization were analyzed as to equality in geographical, socio-economic, and gender distributions. The study base was a cross-sectional mail questionnaire sent in 1992 to all 50-year old persons (totally 8890) in Örebro and Östergötland counties in Sweden. Measures of the variables were all based on self-assessments. The response rate was 71.3%. The results showed no large inequalities as to satisfaction, except the aspect travel time for rural residents. They also had higher perceived need for dental care. For utilization of dental care, workers were relatively fewer among “high” consumers. Controlling for socio-economic group, there were twice as many men than women among “low” consumers. In conclusion, there was relative equality in the dental care delivery in this 50-year old Swedish population, with some remaining social differences, primarily socio-economically contingent.     

Demand for and utilization of dental services among Hong Kong employees with and without dental benefit coverage

Abstract The objectives of the present study were to investigate the effects of employer-provided dental benefits on the pattern of demand for and utilization of denial services among Hong Kong employees and to analyse whether employees' awareness about an existing denial benefit programme influenced their denial service demand and utilization. Staff from 11 selected companies with and without dental benefits responded to questionnaires concerning their personal factors, demand for dental services, and utilization of denial services and about their awareness of their dental benefit coverage. Overall response rate was 67%. The socio-demographic characteristics of those respondents who were covered and those who were not were similar. Forty per cent of the covered respondents were not aware of their dental benefit coverage, so analysis was performed with three groups of respondents, covered and aware, covered and unaware, and uncovered. A larger proportion of employees in the “aware” group had visited a dentist in the previous 12 months and had visited a dentist for asymptomatic reasons. The “aware” group reported more “low expenditure” items and less “high expenditure” items. Those who were aware of their dental benefit coverage irrespective of the type of scheme reported a significantly higher demand than those who were not aware of their coverage. Demand and utilization of the covered, but unaware, group was more similar to the uncovered group than lo the “aware” group. Coverage per se had no apparent effect on the demand for dental services. Further studies will be necessary lo establish that higher dental care demand and utilization induced by third party schemes also leads to improved oral health.     

The utilization of dental care services according to health insurance coverage in Catalonia (Spain)

Abstract –  The aim of this study was to assess the relationship of dental care service use with health insurance and its evolution. The Catalan Health Interview Survey is a cross-sectional study conducted in 1994 ( n  = 15 000) and 2001–2 ( n  = 8400) by interviews at home to a representative sample of Catalonia (Spain). All the estimates were obtained by applying weights to restore the representativeness of the Catalonia general population. In the bivariate analysis, age, gender, social class and health insurance coverage were statistically associated with a dental visit in the previous year ( P  < 0.001). Analysis with logistic regression showed that health insurance status has a statistically significant association with utilization ( P  < 0.001), which was independent of the other socio-economic factors (age, gender, country of birth, and social class). However, the falling trend of differences by health insurance coverage is of note (adjusted OR = 2.2 and 1.5 at 1994 and 2002, respectively); as well as the positive evolution of the overall rate of dental service care use in the previous year, from 26.7% in 1994 to 34.3% in 2002. Future studies will be needed to monitor this tendency.     

Increasing dental care utilization by Medicaid-eligible children: a dental care coordinator intervention

Objectives: The aim of this study was to determine the effect of a dental care coordinator intervention on increasing dental utilization by Medicaid-eligible children compared with a control group.
Methods: One hundred and thirty-six children enrolled in Medicaid aged 4 to 15 years at baseline in 2004 who had not had Medicaid claims for 2 years, were randomly assigned to intervention or control groups for 12 months. Children and caregivers in the intervention group received education, assistance in finding a dentist if the child did not have one, and assistance and support in scheduling and keeping dental appointments. All children continued to receive routine member services from the dental plan administrator, including newsletters and benefit updates during the study.
Results: Dental utilization during the study period was significantly higher in the intervention group (43 percent) than in the control group (26 percent). The effect was even more significant among children living in households well below the Federal Poverty Level. The intervention was effective regardless of whether the coordinator was able to provide services in person or via telephone and mail.
Conclusion: The dental care coordinator intervention significantly increased dental utilization compared with similar children who received routine Medicaid member services. Public health programs and communities endeavoring to reduce oral health disparities may want to consider incorporating a dental care coordinator along with other initiatives to increase dental utilization by disadvantaged children.     

Changes in oral health-related quality of life (OHRQoL) related to long-term utilization of dental care among older people

Objective: To examine whether long-term utilization of dental care, treatment with fillings and crowns and persistent tooth loss between age 50 and 65 years associate with subsequent changes in OHRQoL from age 65 to 70 years.

Method: In 1992, a census of 50-year-olds received invitation to participate in a questionnaire survey. Of 6346 respondents, 3585 completed follow-ups in 1997, 2002, 2007 and 2012. OHRQoL was measured using the Oral Impacts on Daily Performances (OIDP) inventory.

Results: Around 70.4%, 11.2% and 18.4% confirmed respectively, no change, worsening, and improvement in OIDP scores between age 65 and 70 years. Compared to those being permanent non-routine dental attenders, ORs of improving and worsening of OIDP were respectively, 0.4 and 0.6 if being a permanent routine dental attender. ORs for improving OIDP was 1.6 if reporting persistent specialist attendance and 2.5 if having received crowns and fillings. Participants with permanent tooth loss were most likely to both worsen and improve OIDP.

Conclusion: Long-term routine dental attendance and permanent tooth loss occurred as predictors simultaneously for improvement and worsening of OIDP. Accumulation of advantages and disadvantages throughout the life-course increases and decreases the probability of improvement and worsening in OIDP among older people in Sweden.